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Celiac artery aneurysm associated with atherosclerotic common hepatic artery stenosis

D K Papadimitriou1, G A Pitoulias, M D Tachtsi

  • 1Vascular Unit of Second Surgical Department, Aristotle University of Thessaloniki G. Gennimatas Hospital, Greece.

VASA. Zeitschrift Fur Gefasskrankheiten
|June 23, 2005
PubMed

Insights

Celiac artery aneurysms are rare but dangerous. A novel surgical technique combining aneurysmectomy and endarterectomy for a ruptured celiac artery aneurysm with hepatic artery stenosis demonstrated successful outcomes with minimized risk.

Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Interventional Radiology

Background:

  • Celiac artery aneurysms (CAAs) are rare, comprising 4% of splanchnic aneurysms, often linked to media degeneration or atherosclerosis.
  • Rupture risk for CAAs is 13%, with a 40% mortality, contrasting sharply with a 5% mortality for elective repair.
  • Historically, CAAs were often diagnosed upon rupture (80%), but improved diagnostics are increasing early recognition.

Observation:

  • A case of celiac artery aneurysm coexisting with severe atherosclerotic stenosis of the common hepatic artery is presented.
  • Surgical intervention was performed via midline supraumbilical laparotomy.
  • The procedure involved extended partial aneurysmectomy and endarterectomy of the common hepatic artery ostium, with closure using a Dacron patch.

Findings:

  • The surgical technique resulted in an uncomplicated postoperative course.
  • No evidence of liver dysfunction was observed post-surgery.
  • Excellent patency of the common hepatic artery was achieved, indicating successful restoration of blood flow.

Implications:

  • This surgical approach appears to offer favorable results for complex celiac artery aneurysms with associated arterial stenosis.
  • The technique effectively minimizes perioperative risks associated with these rare vascular lesions.
  • Successful management highlights the importance of tailored surgical strategies for splanchnic artery aneurysms.

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