Diagnosis of celiac artery in-stent thrombosis by transesophageal echocardiography

Area of Science:

• Vascular Surgery
• Diagnostic Imaging
• Cardiology

Background:

• Peripheral arterial disease (PAD) can affect visceral arteries, leading to serious complications.
• Celiac artery in-stent thrombosis is a rare but critical complication.
• Transesophageal echocardiography (TEE) is typically used for cardiac assessment, not routine visceral artery evaluation.

Observation:

• A 70-year-old woman with severe PAD presented with symptoms suggestive of visceral ischemia.
• Transesophageal echocardiography (TEE) revealed thrombosis within a celiac artery stent.
• Literature review confirmed visualization of celiac and superior mesenteric arteries is feasible during transgastric views.

Findings:

• TEE successfully diagnosed celiac artery in-stent thrombosis.
• Two-dimensional and color Doppler echocardiography demonstrated intrinsic advantages for assessing aortic and visceral arterial pathology.
• Visceral artery visualization during TEE is achievable and can be integrated into standard protocols.

Implications:

• TEE can be a valuable tool for diagnosing visceral artery pathologies, including in-stent thrombosis.
• Incorporating visceral artery assessment into TEE protocols may improve early diagnosis and patient outcomes.
• Echocardiography offers a potentially superior, non-invasive alternative to CT, MRA, and catheterization for specific vascular assessments.