When is safe to cover the left subclavian and celiac arteries. Part II: celiac artery

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M Gawenda1, J Brunkwall

  • 1Department of Vascular Surgery, University of Cologne, Cologne, Germany. michael.gawenda@uk-koeln.de

The Journal of Cardiovascular Surgery
|July 31, 2008
PubMed

Insights

Covering the celiac artery (CA) during endovascular thoracic aortic repair (TEVAR) is feasible. This review explores CA anatomy and consequences, supporting a diagnostic algorithm for safe TEVAR.

Area of Science:

  • Vascular Surgery
  • Endovascular Interventions
  • Aortic Aneurysm Repair

Background:

  • Endovascular repair is an alternative to open repair for thoracic and thoraco-abdominal aortic aneurysms.
  • Inadequate distal landing zones proximal to the celiac artery necessitate open repair or hybrid/endovascular approaches.
  • Covering the celiac artery origin can extend the distal landing zone for endovascular thoracic aortic repair (TEVAR).

Purpose of the Study:

  • To review the anatomy of the celiac artery (CA) and superior mesenteric artery (SMA).
  • To discuss the consequences of CA coverage during TEVAR.
  • To demonstrate the feasibility of covering the CA during TEVAR using a diagnostic algorithm.

Main Methods:

  • Review of anatomical literature concerning the celiac artery and superior mesenteric artery.
  • Analysis of existing literature on the consequences of celiac artery coverage in TEVAR.
  • Development of a diagnostic algorithm to guide decisions on celiac artery coverage.

Main Results:

  • Detailed review of the anatomical variations and collateral supply related to the celiac artery.
  • Summary of potential complications and management strategies for celiac artery coverage.
  • Demonstration of the feasibility of covering the celiac artery in select cases based on literature.

Conclusions:

  • Celiac artery coverage can be a viable strategy to achieve adequate landing zones in TEVAR.
  • A thorough understanding of anatomy and a diagnostic algorithm are crucial for safe implementation.
  • Further research may refine patient selection and outcomes for TEVAR with celiac artery coverage.

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