A minimally invasive approach for management of pancreaticoduodenal artery and gastroduodenal artery aneurysm with celiac artery occlusion

Kaileen Fei; Sabino Zani Jr; James S Ronald; Cynthia K Shortell; Kevin W Southerland

doi:10.1016/j.jvscit.2023.101180

A minimally invasive approach for management of pancreaticoduodenal artery and gastroduodenal artery aneurysm with celiac artery occlusion

J Vasc Surg Cases Innov Tech. 2023 Apr 7;9(3):101180. doi: 10.1016/j.jvscit.2023.101180. eCollection 2023 Sep.

Authors

Kaileen Fei¹, Sabino Zani Jr², James S Ronald³, Cynthia K Shortell⁴, Kevin W Southerland⁴

Affiliations

¹ Duke University School of Medicine, Durham, NC.
² Division of Surgical Oncology, Department of Surgery, Duke University Medical Center, Durham, NC.
³ Division of Interventional Radiology, Department of Radiology, Duke University Medical Center, Durham, NC.
⁴ Division of Vascular and Endovascular Surgery, Department of Surgery, Duke University Medical Center, Durham, NC.

Abstract

Management of pancreaticoduodenal artery aneurysms (PDAAs) and gastroduodenal artery aneurysms (GDAAs) with concomitant celiac occlusion represents a challenging clinical scenario. Here, we describe a 62-year-old female with PDAA and GDAA complicated by celiac artery occlusion due to median arcuate ligament syndrome. We used a staged, minimally invasive approach consisting of: (1) a robotic median arcuate ligament release; (2) endovascular celiac artery stenting; and (3) visceral aneurysm coiling. The findings from this case report represent a novel treatment strategy for the management of PDAA/GDAA with celiac artery compression secondary to median arcuate ligament syndrome.

Keywords: Gastroduodenal artery aneurysm; Median arcuate ligament syndrome; Minimally invasive; Pancreaticoduodenal artery aneurysm; Visceral artery aneurysm.

Publication types

Case Reports