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Balloon fenestration of iatrogenic celiac artery dissection
Young Ho So1, Jin Wook Chung, Jae Hyung Park
1Department of Radiology, Seoul National University College of Medicine, and the Institute of Radiation Medicine, Seoul National University Medical Research Center, Clinical Research Institute, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea.
Insights
Iatrogenic celiac artery dissection during chemoembolization is rare. Balloon fenestration of the intimal flap successfully recanalized the artery, restoring blood flow.
Area of Science:
- Interventional Radiology
- Vascular Surgery
- Gastroenterology
Background:
- Iatrogenic injury to the celiac artery during catheterization procedures is an uncommon but serious complication.
- Transcatheter arterial chemoembolization (TACE) is a common oncologic treatment, but carries risks of vascular complications.
Observation:
- A case of complete celiac artery occlusion occurred during a TACE procedure due to an iatrogenic intimal dissection.
- The dissection resulted in immediate and complete blockage of blood flow through the celiac artery.
Findings:
- Successful immediate recanalization was achieved using balloon fenestration of the intimal flap.
- Follow-up angiography confirmed the patency of the celiac and common hepatic arteries.
- Mild residual stenosis at the common hepatic artery orifice was noted post-procedure.
Implications:
- Balloon fenestration is a viable and effective technique for managing acute iatrogenic celiac artery dissections during TACE.
- This approach can prevent potentially severe ischemic complications and ensure continued treatment delivery.
- Highlights the importance of prompt recognition and endovascular management of such rare iatrogenic injuries.
Abstract:
Iatrogenic dissections of the celiac artery during catheterization are rare complications. Herein a case is reported in which complete occlusion of the celiac artery occurred during transcatheter arterial chemoembolization and was immediately successfully recanalized with balloon fenestration of the intimal flap. Follow-up angiography showed patent celiac and common hepatic arteries with mild focal residual stenosis of the common hepatic artery orifice.
