J.Jpn. Surg. Soc.. 105(6): 359-363, 2004

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Feature topic

INTERVENTONAL RADIOLOGY IN THE SPLANCHNIC ARTERIES

We present a review of interventional radiology in the splanchnic arteries, focusing on what has been achieved and the remaining challenges. Embolization is currently the treatment of choice for hemorrhagic events due to anastomotic leakage after intestinal anastomosis, although occasional association with liver necrosis poses a hazardous problem yet to be overcome. For splanchnic artery aneurysms, we should recognize that we are not, in reality, well informed about their natural history. The indications for the embolization of aneurysms is limited depending on the morphology of the aneurysm and surrounding vessels. Rotational angiography and other recently developed imaging techniques can help analyze the vascular anatomy of every lesion in decision making on the appropriate treatment for each patient when choosing between embolization and surgical obliteration. Partial splenic artery embolization for hypersplenism has been highly evaluated since the 1980 s, although treatment indication should be carefully studiedfor patients with severe liver dysfunction. For acute mesenteric artery occlusion, local fibrinolysis should always be backed up by or combined with surgical treatment, and the treatment outcome is still sometimes dismal, suggesting one of the boundaries of modern medicine.

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