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Celiac trunk coverage in endovascular aneurysm repair

M Delle1, L Lönn, O Henrikson

  • 1Department of Radiology, Södersjukhuset, Stockholm, Sweden.

Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society
|December 17, 2010
PubMed

Insights

Covering the coeliac trunk during endovascular aneurysm repair may be safe, even without symptoms of intestinal ischemia. Preoperative angiography is recommended to assess collateral flow from the superior mesenteric artery.

Area of Science:

  • Vascular Surgery
  • Endovascular Interventions
  • Aneurysm Treatment

Background:

  • Endografting is a common treatment for aneurysms.
  • Obstruction of the coeliac trunk can occur during endovascular aneurysm repair.
  • Assessing the risks of coeliac trunk coverage is important.

Purpose of the Study:

  • To examine the risks associated with coeliac trunk obstruction during endovascular aneurysm repair.
  • To evaluate the safety and outcomes of intentional coeliac trunk coverage.

Main Methods:

  • Retrospective study of 120 patients treated with endografting for aneurysmal disease.
  • Subgroup analysis of 9 patients with coeliac trunk coverage.
  • Preoperative angiography to assess collateral flow from the superior mesenteric artery.

Main Results:

  • No severe clinical events or intestinal ischemia were observed in patients with coeliac trunk coverage.
  • Three patients experienced a transient increase in liver enzymes.
  • Collateral flow assessment predicted the risk of ischemia.

Conclusions:

  • Coeliac trunk coverage can be a viable option when the landing zone is inadequate for endografting.
  • Preoperative angiography is recommended to evaluate collateral circulation.
  • This approach may be considered when surgical alternatives are limited.
Abstract

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