Treatment Strategies for a Pancreaticoduodenal Artery Aneurysm with or without a Celiac Trunk Occlusive Lesion.

Abstract

OBJECTIVES:

A true pancreaticoduodenal artery aneurysm (PDAA) is a rare disease, and has some unique characteristics: a high rupture risk and a strong correlation with celiac trunk stenotic lesions (CTSL). We showed here that our treatment strategy for PDAA.

MATERIALS AND METHODS:

Seven consecutive patients with PDAA at our institution from 1998 to 2011 were retrospectively reviewed. Of the 7 patients, five were male and two were female, with a mean age of 55 ± 9.7 years. Three aneurysms were diagnosed incidentally, and the remaining four ruptured. The locations of the aneurysm were the anterior superior pancreaticoduodenal artery (ASPDA) in 3 patients and the inferior pancreaticoduodenal artery (IPDA) in four. CTSL found 3 patients in the IPDA.

RESULTS:

Of four ruptured patients, emergency catheter coil embolization was performed in three, and a simple ligation was performed in one. Three patients with non-ruptured aneurysms in the IPDA with a CTSL underwent direct aneurysm resection with arterial reconstruction. Six patients were successfully treated without complications or the appearance of new aneurysms during the follow-up period.

CONCLUSION:

The treatment strategy for PDAA should be selected by the site of the aneurysm, the patients' condition, and the anatomical situation. A hybrid treatment could be considered a beneficial option for a CTSL.

• Authors: Ayako Nishiyama, Katsuyuki Hoshina, Akihiro Hosaka, Hiroyuki Okamoto, Kunihiro Shigematsu, Tetsuro Miyata
• Journal: Annals of vascular diseases (Ann Vasc Dis) Vol. 6 Issue 4 Pg. 725-9 ( 2013) ISSN: 1881-641X [Print] Japan
• PMID: 24386022 (Publication Type: Journal Article)