EUS-guided coil and glue as a first-line treatment for visceral artery pseudoaneurysm: a long-term follow-up study with a proposed algorithmic approach (with video)

Abstract

Background and aims: Visceral artery pseudoaneurysm (PsA) is an uncommon adverse event associated with pancreatitis. In this study, we assessed the safety and efficacy of EUS-guided coil and glue embolization for PsA.

Methods: Patients with visceral artery PsA who underwent EUS-guided embolization as a first-line procedure were included. The primary outcome was clinical success, defined as the complete obliteration of the PsA at 12 weeks.

Results: Nineteen patients with 20 PsAs were included. Mean patient age was 38.63 ± 13.87 years, and 89.5% were men. Splenic artery PsA was the most common (75%). The median size of the PsA was 2.5 cm (IQR, 1.5-4.1). There was a 100% technical success rate and 85% clinical success rate. After the procedure, 1 patient developed splenic abscess. No recurrence was seen after a median follow-up of 37 months.

Conclusions: EUS-guided coil and glue embolization is an effective first-line procedure for splenic artery PsAs.