PMC5040223_01
CT image: Pseudoaneurysm arising from the proximal splenic artery.
poljradiol-81-462-g001.jpg
PMC5040223_01_poljradiol-81-462-g001.jpg
f1-poljradiol-81-462
Triple-phase CT of the abdomen showed a pseudocyst with intracystic bleed and proximal splenic artery pseudoaneurysm of 23x18 mm in size (Figure 1), with thrombosed portal vein, splenic vein, and superior mesenteric vein with collaterals.
DSA image: Direct puncture of pseudoaneurysm by an 18-G needle.
poljradiol-81-462-g002.jpg
PMC5040223_01_poljradiol-81-462-g002.jpg
f2-poljradiol-81-462
Under USG guidance, we directly punctured the pseudoaneurysm with an 18-gauge (VYGON 20 mm-18G-L.90 mm) needle and confirmed the position of the needle by injecting contrast under fluoroscopy (Siemans artis U) (Figure 2).
DSA image: Coil embolization of pseudoaneurysm.
poljradiol-81-462-g003.jpg
PMC5040223_01_poljradiol-81-462-g003.jpg
f3-poljradiol-81-462
Through this needle, IMWCE coils (of the following size: 35-3-3, by cook medical) and tornado coils (35-4/3 by cook medical) were placed in the pseudoaneurysm (Figure 3). During the procedure we simultaneously performed angiography by the transfemoral route via SIM 1 catheter (5 french-0.035 inch-100 cm by cook medical) to check the patency of the splenic artery (Figure 3).
DSA image: Embolized pseudoaneurysm by coils and glue cast.
poljradiol-81-462-g004.jpg
PMC5040223_01_poljradiol-81-462-g004.jpg
f4-poljradiol-81-462
When we confirmed by angiogram that the pseudoaneurysm was embolized by coils, we injected 3 mL of glue and lipoidol combination to completely occlude the pseudoaneurysm (Figure 4).
DSA Image: Post procedure check angiogram - embolized pseudoaneurysm and patent splenic artery.
poljradiol-81-462-g005.jpg
PMC5040223_01_poljradiol-81-462-g005.jpg
f5-poljradiol-81-462
A follow-up angiogram revealed non-filling of the pseudoaneurysm with preservation of the splenic artery (Figure 5).