Current Management of Mesenteric Extrahepatic Arterioportal Fistulas: Report of a Case Treated With a Gastroduodenal Artery Stent Graft and Literature Review
Restricted accessReview articleFirst published online February, 2010
Current Management of Mesenteric Extrahepatic Arterioportal Fistulas: Report of a Case Treated With a Gastroduodenal Artery Stent Graft and Literature Review
Spontaneous arteriovenous fistulation of a pseudoaneurysm into superior mesenteric vein (SMV) has rarely been reported. We present the case of a 61-year-old woman who presented with a post pancreatic arterioportal fistula (APF) that was successfully managed by stent graft (SG) placement in the gastroduodenal artery (GDA). We also review the published experience of the endovascular management of mesenteric extrahepatic APFs. This review demonstrates the evolution from open surgical to endovascular management for majority of these patients.
Pietri J., Remond A., Reix T., Abet D., Sevestre H., Sevestre MAArterioportal fistulas: twelve cases. Ann Vasc Surg. 1990;4(6): 533-539.
2.
Defreyne L., De Schrijver I., Vanlangenhove P., Kunnen M.Detachable balloon embolization of an aneurysmal gastroduodenal arterioportal fistula. Eur Radiol. 2002;12(1):231-236.
3.
Hennessy OF, Gibson RN, Allison DJUse of giant steel coils in the therapeutic embolization of a superior mesenteric artery-portal vein fistula. Cardiovasc Intervent Radiol. 1986;9(1):42-45.
4.
Onitsuka A., Katagiri Y., Shibata M., Hirose H., Shimazaki M.Congenital multiple arterioportal fistula: a case report treated with portocaval shunt. Hepatogastroenterology. 1997;44(17): 1324-1327.
5.
Vauthey JN, Tomczak RJ, Helmberger T., et al. The arterioportal fistula syndrome: clinicopathologic features, diagnosis, and therapy. Gastroenterology. 1997;113(4):1390-1401.
6.
Nakamura T., Isobe Y., Ueno E., Kondoh Y., Yoshida I., Obata H.Successful arterial embolization of arteriovenous fistula in the portal circulation . Gastrointest Radiol. 1992;17(4):324-326.
7.
Denys A., Hammel P., de Baere T., et al. Arterioportal fistula due to a ruptured pancreatic pseudocyst: diagnosis and endovascular treatment. Am J Roentgenol. 1998;170(5):1205-1206.
8.
Capron JP GJ , Remond A.Inferior Mesenteric Arteriovenous fistula associated with portal hypertension and ischemic colitis successful occlusion by intra arterial embolisation with steel coils. Gastroenterology . 1984;86(2):5.
9.
Uflacker R., Saadi J.Transcatheter embolization of superior mesenteric arteriovenous fistula. AJR Am J Roentgenol. 1982; 139(6):1212-1214.
10.
Desai SB, Modhe JM, Aulakh BG, Ravi R., Sukthankar RU, Pardiwalla BBPercutaneous transcatheter steel-coil embolization of a large proximal post-traumatic superior mesenteric arteriovenous fistula. J Trauma. 1987;27(9):1091-1094.
11.
Deitrick J. , McNeill P., Posner MP, et al. Traumatic superior mesenteric artery-portal vein fistula. Ann Vasc Surg. 1990;4(1):72-76.
12.
Miyazaki T. , Yamashita Y., Tomoda K., et al. Transarterial embolization of an extrahepatic portal vein aneurysm with arterioportal fistula. Cardiovasc Intervent Radiol. 1995;18(3):189-191.
13.
Cekirge S., Ozmen M., Akata D., Akhan O., Balkanci F., Besim A.Endovascular treatment of a superior mesenteric arteriovenous fistula by a transhepatic portal venous approach. AJR Am J Roentgenol. 1998;171(5):1283-1284.
14.
Ishigami K. , Yoshimitsu K., Honda H., et al. Coil embolization of arterioportal fistula that developed after partial gastrectomy. Cardiovasc Intervent Radiol. 1999;22(4):328-330.
15.
Marrone G., Caruso S., Miraglia R., Tarantino I., Volpes R., Luca A.Percutaneous transarterial embolization of extrahepatic arteroportal fistula . World J Gastroenterol. 2006;12(34):5562-5564.
16.
Nicholson AA , Patel J., McPherson S., Shaw DR, Kessel D.Endovascular treatment of visceral aneurysms associated with pancreatitis and a suggested classification with therapeutic implications. J Vasc Interv Radiol. 2006;17(8):1279-1285.
17.
Chen Q., Tack C., Morcos M., et al. Embolotherapy of an arterioportal fistula. Cardiovasc Intervent Radiol. 2007;30(5):1047-1051.
18.
Narayanan G., Mohin G., Barbery K., Lamus D., Nanavati K., Yrizarry JMEndovascular management of superior mesenteric artery pseudoaneurysm and fistula . Cardiovasc Intervent Radiol. 2008;31(6):1239-1243.
19.
Wu CG, Li YD, Li MHPost-traumatic superior mesenteric arteriovenous fistula: endovascular treatment with a covered stent. J Vasc Surg. 2008;47(3):654-656.
20.
Weinstein D. , Altshuler A., Belinki A., et al. Superior mesenteric artery to superior mesenteric vein arteriovenous fistula presenting as abdominal pain and gastrointestinal bleeding 3 years after an abdominal gunshot wound: report of a case and review of the literature. J Trauma. 2008;66(1):E13-E16.
21.
Van Way CW 3rd, Crane JM, Riddell DH, Foster JHArteriovenous fistula in the portal circulation . Surgery. 1971;70(6):876-890.
22.
Yamagami T. , Nakamura T., Nishimura T.Portal hypertension secondary to spontaneous arterio-portal venous fistulas: transcatheter arterial embolization with n-butyl cyanoacrylate and microcoils. Cardiovasc Intervent Radiol . 2000;23(5):400-402.
