Celiac Axis Occlusion Research Articles

Transcatheter Coil Embolization of an Arc of Buhler Aneurysm

We report the findings of a patient with an asymptomatic Arc of Buhler (AOB) aneurysm, which was successfully treated by transcatheter coil embolization. An abdominal CT and angiography revealed an intact pancreaticoduodenal artery arcade (PDAA) and an anomalous communication between the SMA and celiac axis, termed an AOB. An aneurysm was observed at the origin of the AOB and treated with a transcatheter embolization using coils. A follow-up CT imaging confirmed the total occlusion of the aneurysm with a patent PDAA. The successful results of this treatment suggest that the endovascular therapy of an AOB aneurysm with a celiac axis occlusion and an intact PDAA is feasible and safe.

A Case of Dorsal Pancreatic Artery Aneurysm with Celiac Axis Occlusion

A 69-year-old woman was admitted to our hospital for the treatment of a dorsal pancreatic artery aneurysm detected with abdominal computed tomography. Angiography revealed celiac axis occlusion, a large aneurysm in the dorsal pancreatic artery, and small aneurysms in the celiac and splenic arteries. Transcatheter arterial embolization with microcoils, N-butylcyanoacrylate, and lipiodol was successfully performed for the dorsal pancreatic artery and the aneurysm. In the 2 years after treatment the dorsal pancreatic artery aneurysm has not recurred, and other aneurysms have not enlarged.

Superior Mesenteric Artery Pseudoaneurysm Associated with Celiac Axis Occlusion Treated Using Endovascular Techniques

The case of a 30-year-old woman with a post-traumatic pseudoaneurysm of the superior mesenteric artery and associated celiac axis occlusion is presented. The patient was successfully treated with celiac artery recanalization and placement of a covered stent within the superior mesenteric artery. Follow-up at 3, 6, and 12 months and 3 years demonstrated patency of the covered stent and continued exclusion of the aneurysm. Although the long-term success of this procedure is unknown this management option should be considered where facilities are available, to reduce the increased morbidity associated with open surgical procedure.

Gastroduodenal Artery Aneurysm Presenting as Jaundice and Abdominal Pain

Visceral artery aneurysm is a very rare and potentially serious vascular anomaly. The mortality rate from bleeding is 40–60%. Aneurysms of the gastroduodenal artery rank among the rarest splanchnic artery aneurysms, comprising fewer than 2 per cent of all such lesions. We report a case of a 41 year old male with history of pancreatitis admitted with jaundice and vague right upper quadrant pain. Laboratory findings suggested a cholestatic picture and ultrasound of the abdomen revealed a mass of the head of the pancreas causing compression of the common bile duct. Further imaging with a CT scan revealed a 5.6 cm aneurysm of the gastroduodenal artery with surrounding hematoma. Mesenteric angiogram showed aneurysm arising from the proximal gastroduodenal artery and occlusion of the celiac axis with multiple collaterals from superior mesenteric artery to the hepatic and splenic arteries. Coil embolisation could result in hepatic ischemia in the setting of celiac axis occlusion, and was not attempted. Patient underwent ERCP and stenting of the common bile duct with successful decompression of the biliary system. Operative exploration with intraoperative visceral angiogram showed celiac axis compression within the medial arcuate ligament of the diaphragm. The medial arcuate ligament was divided leading to restoration of blood flow to the liver. The inflow and outflow vessels of the aneurysms were ligated without the risk of hepatic ischemia. Patient recovered uneventfully. This case illustrates an uncommon cause of obstructive jaundice caused by bleeding aneurysm of the gastroduodenal artery in the settings of prior pancreatitis and celiac axis occlusion.

Pancreaticoduodenal Artery Aneurysms Associated with Celiac Axis Occlusion

True aneurysms of the pancreaticoduodenal artery associated with celiac axis occlusion are very rare; only 38 cases have been reported, according to our literature review. We present three consecutive cases with different options of surgical treatment.

Preservation of collateral pathways during pancreaticoduodenectomy in case of celiac axis occlusion

Preservation of collateral pathways during pancreaticoduodenectomy in case of celiac axis occlusion

Transcatheter Arterial Chemoembolization for Hepatocellular Carcinomas in Patients with Celiac Axis Occlusion

To verify the hypothesis that most instances of celiac axis occlusion in patients with hepatocellular carcinoma (HCC) are caused by diaphragmatic compression and, therefore, transcatheter arterial chemoembolization (TACE) can be performed through the compressed lumen of the celiac axis. The authors attempted to perform TACE in 36 consecutive patients with HCC and celiac axis occlusion. Spiral computed tomographic (CT) images were available in 26 patients. Initially, catheterization of the hepatic arteries was attempted through the occluded celiac axis. If it failed, catheterization was performed through the pancreaticoduodenal arcades. The causes of celiac axis occlusion were evaluated based on spiral CT and angiographic findings, access routes, technical success rates, and related complications in superselective catheterization of hepatic arteries. Among the 26 patients who underwent spiral CT, diaphragmatic compression of the celiac axis was demonstrated in 23. Selective catheterization of hepatic arteries was possible through the occluded celiac axis in 23 patients (64%). In nine (25%) of the remaining 13 patients, TACE was performed through the dilated pancreaticoduodenal arcades from the superior mesenteric artery. As a procedure-related complication, celiac axis dissection occurred in one patient (3%). Most patients with celiac axis occlusion had arcuate ligament compression. In TACE, the celiac artery occlusion could be traversed directly and this should be the initial approach.

Endoprótese no tratamento de angina abdominal grave.

The endovascular treatment (percutaneous transluminal angioplasty and stent placement) is an option to surgical treatment in patients with abdominal angor, with good results by a less invasive way. A case of a patient with superior mesenteric artery occlusion and severe stenosis of celiac axis is presented that was treated by endovascular treatment and stenting, with resolution of the abdominal angor.

Inferior Pancreaticoduodenal Artery Aneurysm in Association with Celiac Axis Occlusion

True aneurysms of the inferior pancreaticoduodenal artery (IPDA) are rare. Nearly half present with rupture. Stenosis or occlusion of the celiac axis is well recognized in association with IPDA aneurysm. The authors report a case of nonruptured IPDA aneurysm that presented with postprandial abdominal pain. Arteriography revealed celiac axis occlusion. The patient was successfully managed by aortohepatic bypass and aneurysm exclusion.

Mesenteric shunting during thoracoabdominal aortic clamping to prevent disseminated intravascular coagulation in dogs.

The current study was undertaken to determine if cold crystalloid perfusion of the mesenteric circulation or continuous arterial shunting into the superior mesenteric artery would prevent the subsequent development of disseminated intravascular coagulation in a dog model. Twenty-two dogs were divided into four groups: those with distal aortic occlusion; those with isolated washout of the mesenteric circulation via the superior mesenteric artery with cold crystalloid; those with continuous isolated arterial perfusion of the superior mesenteric artery via an open proximal aorta; and those with shunting of blood into the superior mesenteric artery from the proximal aorta with an Inahara-Pruitt shunt. Coagulation parameters were measured for 24 hours and compared to the results with 32 dogs in the following groups: sham operation; supraceliac aortic occlusion for 30 minutes, 60 minutes, 90 minutes; superior mesenteric occlusion for 90 minutes; and celiac axis occlusion for 90 minutes. Shunting or direct arterial perfusion of the superior mesenteric artery prevented disseminated intravascular coagulation from occurring. Infrarenal aortic occlusion resulted in no change in any of the coagulation factors, whereas crystalloid perfusion of the superior mesenteric artery resulted in death in all animals. These results indicate that the disseminated intravascular coagulation that occurs with supraceliac aortic occlusion or superior mesenteric occlusion of greater then one hour can be prevented by continuous arterial perfusion of the superior mesenteric artery during proximal aortic clamping.

CT Appearances of celiac axis occlusion with mesenteric steal syndrome—A case report

CT Appearances of celiac axis occlusion with mesenteric steal syndrome—A case report

Ruptured atherosclerotic aneurysm of the superior mesenteric artery with celiac axis occlusion.

Ruptured atherosclerotic aneurysm of the superior mesenteric artery with celiac axis occlusion.