Treatment of ruptured rectal artery aneurysm in a patient with neurofibromatosis
Abstract Background Superior rectal artery (SRA) aneurysms are rare. Although melena is the most common symptom, it has not been observed in cases of aneurysms located in the SRA trunk. Here, we report a case of a ruptured SRA trunk aneurysm successfully treated with coil embolization. Including our...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-08-01
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| Series: | CVIR Endovascular |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42155-022-00317-y |
| _version_ | 1798038074127548416 |
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| author | Hidehiko Nemoto Kensaku Mori Yohei Takei Shunsuke Kikuchi Sodai Hoshiai Yoshiyuki Yamamoto Takahito Nakajima |
| author_facet | Hidehiko Nemoto Kensaku Mori Yohei Takei Shunsuke Kikuchi Sodai Hoshiai Yoshiyuki Yamamoto Takahito Nakajima |
| author_sort | Hidehiko Nemoto |
| collection | DOAJ |
| description | Abstract Background Superior rectal artery (SRA) aneurysms are rare. Although melena is the most common symptom, it has not been observed in cases of aneurysms located in the SRA trunk. Here, we report a case of a ruptured SRA trunk aneurysm successfully treated with coil embolization. Including our case, three of the four reported cases of SRA trunk aneurysms were related to neurofibromatosis type 1 (NF1). Case presentation A 52-year-old woman with NF1 was referred to our hospital for the investigation of an abdominal mass with back pain. She had previously undergone a blood transfusion at another hospital for anemia without melena. Computed tomography angiography revealed a ruptured SRA trunk aneurysm measuring 3 cm in diameter and surrounded by a retroperitoneal hematoma. The aneurysm was isolated by embolizing the SRA trunk distally and proximally. Distal embolization was performed retrogradely from the internal iliac artery (IIA) via the middle rectal artery (MRA)-SRA anastomosis because the antegrade approach from the inferior mesenteric artery (IMA) failed. To our knowledge, this is the first case of successful coil embolization of an IMA branch through the IIA. Conclusion SRA trunk aneurysms are rare; however, they are frequently associated with NF1. Antegrade distal embolization beyond the aneurysm is sometimes difficult to achieve. In such cases, a retrograde approach via MRA-SRA anastomosis can be the choice for isolating SRA trunk aneurysms. |
| first_indexed | 2024-04-11T21:35:15Z |
| format | Article |
| id | doaj.art-e3f292f2ff0e4e29af31825767c5bb7e |
| institution | Directory Open Access Journal |
| issn | 2520-8934 |
| language | English |
| last_indexed | 2024-04-11T21:35:15Z |
| publishDate | 2022-08-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | CVIR Endovascular |
| spelling | doaj.art-e3f292f2ff0e4e29af31825767c5bb7e2022-12-22T04:01:46ZengSpringerOpenCVIR Endovascular2520-89342022-08-01511510.1186/s42155-022-00317-yTreatment of ruptured rectal artery aneurysm in a patient with neurofibromatosisHidehiko Nemoto0Kensaku Mori1Yohei Takei2Shunsuke Kikuchi3Sodai Hoshiai4Yoshiyuki Yamamoto5Takahito Nakajima6Department of Radiology, University of Tsukuba HospitalDepartment of Radiology, Faculty of Medicine, University of TsukubaDepartment of Radiology, University of Tsukuba HospitalDepartment of Radiology, Tsuchiura Kyodo General HospitalDepartment of Radiology, Faculty of Medicine, University of TsukubaDepartment of Gastroenterology, Faculty of Medicine, University of TsukubaDepartment of Radiology, Faculty of Medicine, University of TsukubaAbstract Background Superior rectal artery (SRA) aneurysms are rare. Although melena is the most common symptom, it has not been observed in cases of aneurysms located in the SRA trunk. Here, we report a case of a ruptured SRA trunk aneurysm successfully treated with coil embolization. Including our case, three of the four reported cases of SRA trunk aneurysms were related to neurofibromatosis type 1 (NF1). Case presentation A 52-year-old woman with NF1 was referred to our hospital for the investigation of an abdominal mass with back pain. She had previously undergone a blood transfusion at another hospital for anemia without melena. Computed tomography angiography revealed a ruptured SRA trunk aneurysm measuring 3 cm in diameter and surrounded by a retroperitoneal hematoma. The aneurysm was isolated by embolizing the SRA trunk distally and proximally. Distal embolization was performed retrogradely from the internal iliac artery (IIA) via the middle rectal artery (MRA)-SRA anastomosis because the antegrade approach from the inferior mesenteric artery (IMA) failed. To our knowledge, this is the first case of successful coil embolization of an IMA branch through the IIA. Conclusion SRA trunk aneurysms are rare; however, they are frequently associated with NF1. Antegrade distal embolization beyond the aneurysm is sometimes difficult to achieve. In such cases, a retrograde approach via MRA-SRA anastomosis can be the choice for isolating SRA trunk aneurysms.https://doi.org/10.1186/s42155-022-00317-ySuperior rectal arteryAneurysmRuptureNeurofibromatosis type 1EmbolizationCoils |
| spellingShingle | Hidehiko Nemoto Kensaku Mori Yohei Takei Shunsuke Kikuchi Sodai Hoshiai Yoshiyuki Yamamoto Takahito Nakajima Treatment of ruptured rectal artery aneurysm in a patient with neurofibromatosis CVIR Endovascular Superior rectal artery Aneurysm Rupture Neurofibromatosis type 1 Embolization Coils |
| title | Treatment of ruptured rectal artery aneurysm in a patient with neurofibromatosis |
| title_full | Treatment of ruptured rectal artery aneurysm in a patient with neurofibromatosis |
| title_fullStr | Treatment of ruptured rectal artery aneurysm in a patient with neurofibromatosis |
| title_full_unstemmed | Treatment of ruptured rectal artery aneurysm in a patient with neurofibromatosis |
| title_short | Treatment of ruptured rectal artery aneurysm in a patient with neurofibromatosis |
| title_sort | treatment of ruptured rectal artery aneurysm in a patient with neurofibromatosis |
| topic | Superior rectal artery Aneurysm Rupture Neurofibromatosis type 1 Embolization Coils |
| url | https://doi.org/10.1186/s42155-022-00317-y |
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