V G McDermott

Successful Endovascular Treatment of a Celiac Artery Pseudoaneurysm Complicating Pancreatitis

O SCVIR. 1996 A visceral arterial pseudoaneurysm is a potentially life-threatening complication of pancreatitis. Pseudoaneurysms occur in approximately 10% of patients with severe pancreatitis (1) and are usually associated with severe gastrointestinal bleeding (2). They may be demonstrated by ultrasonography (US), computed tomography (CT), magnetic resonance (MR) imaging, or arteriography. The splenic artery and gastroduodenal arteries are commonly involved, but celiac artery involvement is rare (3). The lesions may be treated surgically or by transcatheter embolization. Tissue necrosis is a potential complication of embolization and in the case of celiac embolization could affect the liver, spleen, stomach, and lower esophagus. To the best of our knowledge, we report the first case of a celiac artery pseudoaneurysi complicating pancreatitis to be successfully treated by transcatheter embolization.

Prospective Evaluation of Pulmonary Artery Pressures during Pulmonary Angiography Performed with Low-Osmolar Nonionic Contrast Media

PURPOSE To determine the effects of pulmonary angiography performed with low-osmolar, nonionic contrast media on pulmonary artery pressures. PATIENTS AND METHODS In a prospective, uncontrolled clinical trial, pulmonary artery pressures (systolic, diastolic, mean) of 116 patients referred for pulmonary angiography were recorded before and 1 and 5 minutes after injection of contrast material. RESULTS There was a statistically significant rise in systolic, diastolic, and mean pulmonary artery pressure at 1 minute (4.6, 3.4, 4.1 mm Hg, respectively) and 5 minutes (3.8, 2.7, 3.4 mm Hg, respectively) after the initial contrast material injection (P < .05). Increases were smaller with additional injections. Systolic pressure changes at 1 and 5 minutes after the first injection were linearly dependent on the volume of contrast material injected (P < .05). There was no statistically significant difference in the increase in pulmonary artery pressure between patients with pulmonary embolus or pulmonary arterial hypertension and those without. CONCLUSION There is a small but statistically significant rise in pulmonary artery pressure after injection of low-osmolar, nonionic contrast material for pulmonary angiography; it is unlikely to be of clinical significance.