Unusual stent assisted coil embolization of superior mesenteric artery ostium aneurysm using Direxion™ and Interlock-18.
Baseline
81-years old man with an history of aortic aneurism underwent TC control and showed a widening of the superior mesenteric artery ostium diameter of 13.1 mm x 20 mm of lenght.
The angiographic control confirmed this enlargement and the presence of the renal arteries close to the point of treatment.
Creating route
We use a triple point of access. Leaving a diagnostic catheter inside the aneurysm sac we positioned an uncovered aortic self-expandable stent, being careful to avoid renal arteries covering.
After that we go through the closed cell of the stent and we used a balloon to enlarge the strut.
After that we positioned a self-expandable covered stent to exclude the aneurysm sac.
Embolization
In order to provide a perfect coil release we choose to use a Direxion™ 0.021" (0.53 mm) Straight Tip microcatheter using the diagnostic catheter left inside the aneurysm sac.
We put three Interlock-18 fibered coils, two 10 x 50 mm and one coil 10 x 30 mm.
Thanks to the great torquability we were able to choose the right coil shaping direction, avoiding coil migration.
Dott. Fabio Melchiorre – Interventional Radiologist –San Paolo Hospital – Milano
Dott. Matteo Crippa – Vascular Surgeon – San Paolo Hospital – Milano