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Endovascular Management of Ruptured Pancreaticoduodenal Artery Aneurysms Associated with Celiac Axis Stenosis

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Abstract

The purpose of this study was to assess the efficacy of transcatheter arterial embolization for ruptured pancreaticoduodenal artery (PDA) aneurysms associated with celiac axis stenosis (CS). Seven patients (four men and three women; mean age, 64; range, 43–84) were treated with transcatheter arterial embolization between 2002 and 2007. They were analyzed with regard to the clinical presentation, radiological finding, procedure, and outcome. All patients presented with sudden epigastric pain or abdominal discomfort. Contrast-enhanced CT showed a small aneurysm and retroperitoneal hematoma around the pancreatic head in all patients. The aneurysms ranged from 0.3 to 0.9 cm in size. In one patient, two aneurysms were detected. The aneurysms were located in the pancreaticoduodenal artery (n = 5) and the dorsal pancreatic artery (n = 3). Embolization was performed with microcoils in all aneurysms (n = 8). N-Butyl 2-cyanoacrylate (n = 1) and gelatine particle (n  = 1) were also used. Complete occlusion was achieved in four patients. In the other three patients, a significantly reduced flow to the aneurysm remained at final angiography. However, these aneurysms were thrombosed on follow-up CT within 2 weeks. And there was no recurrence of the symptoms and bleeding during follow-up (mean, 28 months; range, 5–65 months) in all patients. In conclusion, transcatheter arterial embolization for PDA aneurysms associated with CS is effective. Significant reduction of the flow to the aneurysm at final angiography may be predictive of future thrombosis.

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Authors and Affiliations

  1. Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Shouwa-ku, Nagoya, 466-8550, Japan

    Kojiro Suzuki, Yasushi Tachi, Yoshine Mori, Tomohiro Komada, Masaya Matsushima, Toyohiro Ota & Shinji Naganawa

  2. Department of Radiology, Toyota Memorial Hospital, 1-1 Heiwa-cho, Toyota, 471-8513, Japan

    Shinji Ito

  3. Department of Radiology, Yokkaichi Municipal Hospital, 2-2-37 Shibata, Yokkaichi, 510-8567, Japan

    Kunihiro Maruyama

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  1. Kojiro Suzuki
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  2. Yasushi Tachi
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  3. Shinji Ito
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  4. Kunihiro Maruyama
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  5. Yoshine Mori
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  6. Tomohiro Komada
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  7. Masaya Matsushima
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  8. Toyohiro Ota
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  9. Shinji Naganawa
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Correspondence to Kojiro Suzuki.

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Suzuki, K., Tachi, Y., Ito, S. et al. Endovascular Management of Ruptured Pancreaticoduodenal Artery Aneurysms Associated with Celiac Axis Stenosis. Cardiovasc Intervent Radiol 31, 1082–1087 (2008). https://doi.org/10.1007/s00270-008-9343-3

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  • DOI: https://doi.org/10.1007/s00270-008-9343-3

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