Top

CardioVascular and Interventional Radiology

Published in:

01-06-2013 | Review/State of the Art

Inferior Pancreaticoduodenal Artery Aneurysms Associated with Occlusive Lesions of the Celiac Axis: Diagnosis, Treatment Options, Outcomes, and Review of the Literature

Authors: Karen Flood, Anthony A. Nicholson

Published in: CardioVascular and Interventional Radiology | Issue 3/2013

Abstract

Purpose

To describe the presentation, treatment, and outcomes for 14 patients with aneurysms of the inferior pancreaticoduodenal arteries associated with occlusive lesions of the celiac axis, and to review the literature for similar cases.

Methods

Over a period of 12 years, 14 patients (10 women and 4 men) ranging in age from 26 to 50 (mean 46) years were demonstrated to have aneurysms of the inferior pancreaticoduodenal artery origin associated with stenosis or occlusion of the celiac axis. All patients were treated by a combination of surgery and interventional radiology.

Results

Outcome data collected between 3 months and 4 years (mean 2 years) demonstrated that all aneurysms remained excluded, and all 14 patients were well. The 49 case reports in the literature confirm the findings of this cohort.

Conclusion

In inferior pancreaticoduodenal artery aneurysm resulting from celiac occlusive disease, endovascular treatment is best achieved by stenting the celiac axis and/or embolizing the aneurysm when necessary.

Uher P, Nyman U, Ivancev K et al (1995) Aneurysms of the pancreaticoduodenal artery associated with occlusion of the celiac artery. Abdom Imaging 20:470–473PubMedCrossRef

Lois JF, Falchuk KH, Peterson LM et al (1983) Spontaneous obliteration of pancreaticoduodenal artery aneurysm after retroperitoneal haemorrhage. Cardiovasc Intervent Radiol 6:47–50PubMedCrossRef

Eckhauser FE, Stanley JC, Zelenock GB et al (1980) Gastroduodenal and pancreaticoduodenal artery aneurysms: a complication of pancreatitis causing spontaneous gastrointestinal haemorrhage. Surgery 88:335–344PubMed

Kalva SP, Athanasoulis CA, Greenfield AJ et al (2006) Inferior pancreaticoduodenal artery aneurysms in association with coeliac axis stenosis or occlusion. Eur J Vasc Endovasc Surg 33:670–675CrossRef

Sutton D, Lawton G (1973) Coeliac stenosis or occlusion with aneurysm of the collateral supply. Clin Radiol 24:49–53PubMedCrossRef

Kadir S, Athanasoulis CA, Yune HY et al (1978) Aneurysms of the pancreaticoduodenal arteries in association with celiac axis occlusion. Cardiovasc Radiol 1:173–177PubMedCrossRef

Bratby MJ, Lehman ED, Bottomley J et al (2006) Endovascular embolization of visceral artery aneurysms with ethylene–vinyl alcohol (Onyx): a case series. Cardiovasc Intervent Radiol 29:1125–1128PubMedCrossRef

Weber CH, Pfeifer KJ, Tato F et al (2005) Transcatheter embolisation of an aneurysm of the pancreaticoduodenal artery with occluded celiac trunk. Cardiovasc Intervent Radiol 28:259–261PubMedCrossRef

Quandalle P, Chambon JP, Marache P et al (1990) Pancreaticoduodenal artery aneurysms associated with coeliac axis stenosis: report of two cases and review of the literature. Ann Vasc Surg 4:540–545PubMedCrossRef

10.

Coll DP, Ierardi R, Kerstein MD et al (1998) Aneurysms of the pancreaticoduodenal arteries: a change in management. Ann Vasc Surg 12:286–291PubMedCrossRef

11.

Akatsu T, Hayashi S, Takashi Y et al (2004) Emergency embolisation of a ruptured pancreaticoduodenal artery aneurysm associated with the median arcuate ligament syndrome. J Gastroenterol Hepatol 19:482–483PubMedCrossRef

12.

Kobayashi T, Uenoyama S, Isogai S (2004) Successful transcatheter embolisation of an inferior pancreaticoduodenal artery aneurysm associated with coeliac axis stenosis. J Gastroenterol Hepatol 19:599–601PubMedCrossRef

13.

Suzuki K, Kashimura H, Sato M et al (1998) Pancreaticoduodenal artery aneurysms associated with coeliac axis stenosis due to compression of the median arcuate ligament and coeliac plexus. J Gastroenterol 33:434–438PubMedCrossRef

14.

Mora JD, Obst D (1976) Celiac axis artery stenosis with aneurismal calcification of the collateral supply. Australas Radiol 20:252PubMedCrossRef

15.

Proud G, Chamberlain J (1978) Aneurysm formation on the small pancreatic arteries in association with celiac axis compression. Ann R Coll Surg Engl 60:294–297PubMed

16.

Patten RM, Coldwell DM, Ben-Menachem Y (1991) Ligamentous compression of the celiac axis: CT findings in five patients. AJR Am J Roentgenol 156:1101–1103PubMedCrossRef

17.

Hayashi T, Nagasue N, Chang YC et al (1989) Duodenal stenosis caused by ruptured aneurysms of the pancreaticoduodenal artery—a case report. Jpn J Surg 19:63–66PubMedCrossRef

18.

Song SY, Chung JW, Kwon JW et al (2002) Collateral pathways in patients with celiac axis stenosis: angiographic-spiral CT correlation. Radiographics 22:881–893PubMed

19.

Bertelli E, Di Gregorio F, Mosca S et al (1996) The arterial blood supply of the pancreas: an anatomical review and radiological study. Surg Radiol Anat 20:445–452

20.

Grech P, Rowlands P, Crofton M (1989) Aneurysm of the inferior pancreaticoduodenal artery diagnosed by real-time ultrasound and pulsed Doppler. Br J Radiol 62:753–755PubMedCrossRef

21.

Foster DR (1985) Inferior pancreatico-duodenal artery aneurysm presenting in a young woman. Br J Radiol 58:1127–1129PubMedCrossRef

22.

Ogino H, Sato Y, Banno T et al (2002) Embolisation in a patient with ruptured inferior pancreaticoduodenal artery aneurysm with median arcuate ligament syndrome. Cardiovasc Intervent Radiol 25:318–319PubMedCrossRef

23.

De Virgilio C, Donayre C, Maher S et al (1997) Inferior pancreaticoduodenal artery aneurysm in association with celiac axis occlusion. J Vasc Endovasc Surg 31:806–810

24.

Iyomasa S, Matsuzaki Y, Hiei K (1995) Pancreaticoduodenal artery aneurysm: a case report and review of the literature. J Vasc Surg 22:161–166PubMedCrossRef

25.

Boijsen E, Gothlin J, Hallbook T et al (1969) Preoperative angiographic diagnosis of bleeding aneurysms of abdominal visceral arteries. Radiology 93:781–791PubMed

26.

De Perrot M, Berney T, Deleaval J et al (1999) Management of true aneurysms of the pancreaticoduodenal arteries. Ann Surg 229:416–420PubMedCrossRef

27.

Ducasse E, Roy F, Chevalier J et al (2004) Aneurysm of the pancreaticoduodenal arteries with a celiac trunk lesion: current management. J Vasc Surg 39:906–911PubMedCrossRef

28.

Chiang KS, Johnson MC, McKusick MA et al (1994) Management of inferior pancreaticoduodenal artery aneurysms: a 4-year, single center experience. Cardiovasc Intervent Radiol 17:217–221PubMedCrossRef

29.

Savastano S, Feltrin GP, Miotto D et al (1995) Embolization of ruptured aneurysm of the pancreaticoduodenal artery secondary to long-standing stenosis of the celiac axis: case reports. Vasc Endovasc Surg 29:309–314CrossRef

30.

Paty PSK, Cordero JA, Clement Darling R et al (1996) Aneurysms of the pancreaticoduodenal artery. J Vasc Surg 23:710–713PubMedCrossRef

31.

Roberts AB, Roslyn JJ, Gahtan V et al (1998) Changing patterns in the diagnosis and treatment of pancreaticoduodenal artery aneurysms: a case report. Vasc Endovasc Surg 32:433CrossRef

32.

McWilliams RG, Persijn Van Meerten EL, Porte RJ et al (1999) Ruptured high-flow aneurysm of the posterior pancreaticoduodenal artery: diagnosis and treatment. Emerg Radiol 6:355–357CrossRef

33.

Tarazov PG, Ignashov AM, Pavlovskij AV et al (2001) Pancreaticoduodenal artery aneurysm associated with celiac axis stenosis combined angiographic and surgical treatment. Dig Dis Sci 46:1232–1235PubMedCrossRef

34.

Tien Y, Kao H, Wang H (2004) Celiac artery stenting: a new strategy for patients with pancreaticoduodenal artery aneurysm associated with stenosis of the celiac artery. J Gastroenterol 39:81–85PubMedCrossRef

35.

Tori M, Nakahara M, Akamatsu H et al (2006) Significance of intraoperative monitoring of arterial blood flow velocity and hepatic venous oxygen saturation for performing minimally invasive surgery in a patient with multiple calcified pancreaticoduodenal aneurysms with celiac artery occlusion. J Hepatobiliary Pancreat Surg 13:472–476PubMedCrossRef

36.

Messina F, Azzena G, Anania G et al (2006) Pancreaticoduodenal artery aneurysm ruptured into duodenum, associated with celiac trunk stenosis. Case report and review of literature. EJVES Extra 12:15–18CrossRef

37.

Wu W, Yu Y, Yang F et al (2006) Transcatheter embolotherapy: posterior pancreaticoduodenal artery aneurysm. Chin J Radiol 31:195–201

38.

Murata S, Tajima H, Fukunaga T et al (2006) Management of pancreaticoduodenal artery aneurysms: results of superselective transcatheter embolization. AJR Am J Roentgenol 187:290–298CrossRef

39.

De Moya MA, Reisner AT, LaMuraglia GM et al (2008) Case 1—2008: a 45-year-old man with sudden onset of abdominal pain and hypotension. N Engl J Med 358:178–186PubMedCrossRef

40.

Manghat NE, Mitchell G, Hay CS et al (2008) The median arcuate ligament syndrome revisited by CT angiography and the use of ECG gating—a single centre case series and literature review. Br J Radiol 81:735–742PubMedCrossRef

41.

Ritter JC, Johnston M, Caruana MF et al (2010) Aorto-gastroduodenal bypass grafting for an inferior pancreaticoduodenal aneurysm and celiac trunk thrombosis. Interact Cardiovasc Thorac Surg 10:125–127PubMedCrossRef

42.

Imamura M, Shiiya N, Murashita T et al (1998) Pancreaticoduodenal artery aneurysm with celiac trunk occlusion. Cardiovasc Surg 39:565–567

43.

Peterson BG, Resnick SA, Eskandari MK (2003) Coil embolization of an inferior pancreaticoduodenal artery aneurysm associated with celiac artery occlusion. Cardiovasc Surg 11:515–519PubMedCrossRef

44.

Teng W, Sarfati MR, Mueller MT et al (2006) A ruptured pancreaticoduodenal artery aneurysm repaired by combined endovascular and open techniques. Ann Vasc Surg 20:792–795PubMedCrossRef

45.

Bageacu S, Cuilleron M, Kaczmarek D et al (2006) True aneurysms of the pancreaticoduodenal artery: successful non-operative management. Surgery 139:608–616PubMedCrossRef

46.

Dave B, Sharma A, Kwolek C et al (2010) Percutaneous transcatheter arterial embolization of inferior-pancreatico-duodenal artery aneurysms associated with celiac artery stenosis or occlusion. Catheter Cardiovasc Interv 75:663–672PubMedCrossRef

47.

Bowens NM, Woo EY, Fairman RM (2011) Reno-hepatic artery bypass for an inferior pancreaticoduodenal artery aneurysm with associated celiac occlusion. Vasc Surg 53:1696–1698CrossRef

Title: Inferior Pancreaticoduodenal Artery Aneurysms Associated with Occlusive Lesions of the Celiac Axis: Diagnosis, Treatment Options, Outcomes, and Review of the Literature
Authors: Karen Flood
Anthony A. Nicholson
Publication date: 01-06-2013
Publisher: Springer-Verlag
Published in: CardioVascular and Interventional Radiology / Issue 3/2013
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-012-0473-2

At a glance: The STEP trials

Springer Medicine

Inferior Pancreaticoduodenal Artery Aneurysms Associated with Occlusive Lesions of the Celiac Axis: Diagnosis, Treatment Options, Outcomes, and Review of the Literature

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 3/2013

Standards of Practice in Transarterial Radioembolization

Percutaneous CT-Guided Biopsy of C3 Vertebral Body: Modified Approach for an Old Procedure

Suitability of Exoseal Vascular Closure Device for Antegrade Femoral Artery Puncture Site Closure

Endovascular Treatment of Diabetic Foot in a Selected Population of Patients with Below-the-Knee Disease: Is the Angiosome Model Effective?

Secure Transhepatic Biliary Access can be Recovered by Skewering a Displaced Looped Biliary Drainage Catheter

Bradycardia Associated With Drug-Eluting Beads Loaded With Irinotecan (DEBIRI) Infusion for Colorectal Liver Metastases