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CardioVascular and Interventional Radiology

, Volume 30, Issue 3, pp 504–507 | Cite as

Coil Embolization of Pancreaticoduodenal Artery Aneurysms Associated with Celiac Artery Stenosis: Report of Three Cases

  • Osamu IkedaEmail author
  • Yoshitaka Tamura
  • Yutaka Nakasone
  • Kohichi Kawanaka
  • Yasuyuki Yamashita
Article

Abstract

Aneurysms of the pancreaticoduodenal artery are rare. Degeneration of pancreaticoduodenal arcade vessels due to these aneurysms is associated with celiac artery stenosis or occlusion. Untreated lesions enlarge progressively and may rupture spontaneously. As the location of aneurysms of pancreaticoduodenal arcade vessels renders their surgical extirpation a challenge, we examined whether endovascular techniques offer a treatment alternative. We report on 3 patients with aneurysms of the pancreaticoduodenal arcade vessels and concomitant celiac artery stenosis/occlusion due to compression by the median arcuate ligament or chronic pancreatitis. All patients were treated by percutaneous coil embolization of the aneurysm. The aneurysmal sac was successfully excluded and the native circulation was preserved. Endovascular surgery can be used to treat these aneurysms safely and permits retention of the native circulation.

Keywords

Aneurysm Celiac artery stenosis Transarterial embolization (TAE) 

References

  1. 1.
    Stanly JC, Whitehouse WM (1984) Splanchnic artery aneurysms. In: Rutherford RB (ed) Vascular surgery. WB Saunders, Philadelphia, pp 798–813Google Scholar
  2. 2.
    Paterson BG, Resnick SA, Eskandari MK (2003) Coil embolization of an inferior pancreaticoduodenal artery aneurysm associated with celiac artery occlusion. Cardiovasc Surg 11:515–519CrossRefGoogle Scholar
  3. 3.
    Chiou AC, Josephs LG, Mezoian JO (1993) Inferior pancreaticoduodenal artery aneurysm: Rupture of a case and review of the literature. J Vasc Surg 17:784–789PubMedCrossRefGoogle Scholar
  4. 4.
    Zelenock GB, Stanley JC (2000) Splanchnic artery aneurysm. In: Rutherford RB (ed) Vascular surgery, 5th edn. WB Saunders, Philadelphia, pp 1369–1382Google Scholar
  5. 5.
    Iyomasa S, Matsuzaki Y, Hiei K, et al. (1995) Pancreaticoduodenal artery aneurysm: A case report and review of the literature. J Vasc Surg 22:161–166PubMedCrossRefGoogle Scholar
  6. 6.
    Reuter SR, Olin T (1965) Stenosis of the celiac artery. Radiology 85:616–627PubMedGoogle Scholar
  7. 7.
    Derrick JR, Pollard HS, Moore RM (1959) The pattern of arteriosclerotic narrowing of the celiac and superior mesenteric arteries. Ann Surg 149:684–689PubMedCrossRefGoogle Scholar
  8. 8.
    Bron KM, Redman HC (1969) Splanchnic artery stenosis and occlusion: Incidence, arteriographic and clinical manifestations. Radiology 92:323–328PubMedGoogle Scholar
  9. 9.
    Levin DC, Baltaxe HA (1972) High incidence of celiac axis narrowing in asymptomatic individuals. AJR Am J Roentgenol 116:426–429Google Scholar
  10. 10.
    Stanley JC, Thompson NW, Fry WJ (1970) Splanchnic artery aneurysms. Arch Surg 10:689–697Google Scholar
  11. 11.
    Gouny P, Fukui S, Aymard A, et al. (1994) Aneurysm of the gastroduodenal artery associated with stenosis of superior mesenteric artery. Am Vasc Surg 8:281–284CrossRefGoogle Scholar
  12. 12.
    Suzuki K, Kashimura H, Sato M, et al. (1998) Pancreaticoduodenal artery aneurysms associated with celiac axis stenosis due to compression by median arcuate ligament and celiac plexus. J Gastroenterol 33:434–438PubMedCrossRefGoogle Scholar
  13. 13.
    Kobayashi S, Yamaguchi A, Isogai M, et al. (1999) Successful transcatheter embolization of a pancreaticoduodenal artery aneurysm in associated with celiac axis occlusion: A case report. Hepato Gastroenterol 46:2991–2994Google Scholar
  14. 14.
    Tarazov PG, Ignashov AM, Pavloskij AV, et al. (2001) Pancreaticoduodenal artery aneurysm associated with celiac axis stenosis: Combined angiographic and surgical treatment. Dig Dis Sci 46:1232–1235PubMedCrossRefGoogle Scholar
  15. 15.
    Lindner HH, Kemprud E (1971) A clinicoanatomic study of the arcuate ligament of the diaphragm. Arch Surg 103:600–605PubMedGoogle Scholar
  16. 16.
    Szilagyi DE, Ryan RL, Elliott JP, Smith JP (1972) The celiac artery compression syndrome: Does it exist? Surgery 72:849–863PubMedGoogle Scholar
  17. 17.
    Bron KM, Redman HC (1969) Splanchnic artery stenosis and occlusion: Incidence, arteriographic and clinical manifestations. Radiology 92:323–328PubMedGoogle Scholar
  18. 18.
    Reuter S (1971) Accentuation of celiac compression by the median arcuate ligament of the diaphragm during deep expiration. Radiology 98:561PubMedGoogle Scholar
  19. 19.
    Cornell S (1971) Severe stenosis of celiac axis: Analysis of patients with and without symptoms. Radiology 99:311PubMedGoogle Scholar
  20. 20.
    Randall M, Patten D, CoIdwell M, Ben-Menachern Y (1991) Ligamentous Compression of the celiac axis: CT findings in five patients. AJR Am J Roentgenol 156:1101–1103Google Scholar
  21. 21.
    Coll DP, Ierardi R, Kerstein MD, et al. (1998) Aneurysms of the pancreaticoduodenal arteries: A change in management. Am Vasc Surg 12:286–291CrossRefGoogle Scholar
  22. 22.
    Mandel SR, Jaques PF, Sanofsky S, et al. (1987) Nonoperative management of peripancreatic arterial aneurysms. A 10-year experience. Ann Surg 205:126–128PubMedCrossRefGoogle Scholar
  23. 23.
    Paterson GB, Resnik AS, Eskandart KM (2003) Coil embolization of an inferior pancreaticoduodenal artery aneurysm associated with celiac artery occlusion. Cardiovasc Surg 11:515–519CrossRefGoogle Scholar
  24. 24.
    Ogino H, Sato Y, Banno T, et al. (2002) Embolization in a patients with ruptured anterior inferior pancreaticoduodenal arterial aneurysm with median arcuate ligament. Cardiovasc Intervent Radiol 25:318–319PubMedCrossRefGoogle Scholar
  25. 25.
    Kobayashi T, Uenoyama S, Isogai S (2004) Successful transcatheter arterial embolization of an inferior pancreaticoduodenal artery aneurysm associated with celiac axis stenosis. J Gastroenterol Hepatol 19:599–601PubMedCrossRefGoogle Scholar
  26. 26.
    Harbin S, Rosenthal D, Fuller T, et al. (1983) Pancreaticoduodenal artery aneurysm: Nonoperative management. J MAG 72:627–628Google Scholar
  27. 27.
    Lossing GA, Grosman H, Mustard R, et al. (1995) Emergency embolization of a rupture aneurysm of the pancreaticoduodenal arcade. CJS 38:363–365Google Scholar
  28. 28.
    Yamamoto T, Miyayama S, Sanada J, et al. (1999) Transarterial treatment of ruptured aneurysm of the pancreaticoduodenal artery associated with stenosis of the celiac trunk: Two case reports. Jpn J Interv Radiol 14:75–79Google Scholar
  29. 29.
    Sultan S, Molly M, Evoy D, et al. (2002) Endovascular management of a pancreaticoduodenal aneurysm: A clinical dilemma. J Endovasc Ther 9:225–228PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2007

Authors and Affiliations

  • Osamu Ikeda
    • 1
    Email author
  • Yoshitaka Tamura
    • 1
  • Yutaka Nakasone
    • 1
  • Kohichi Kawanaka
    • 1
  • Yasuyuki Yamashita
    • 1
  1. 1.Department of Diagnostic RadiologyKumamoto University Graduate School of Medical and Pharmaceutical SciencesKumamotoJapan

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