Sutton-Kadir Syndrome can be treated safely with endovascular embolisation alone

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Gastroenterology

Background:

• Sutton-Kadir Syndrome (SKS) is characterized by true inferior pancreaticoduodenal artery (IPDA) aneurysms associated with coeliac artery (CA) stenosis or occlusion.
• Ruptured SKS aneurysms pose a significant morbidity risk, yet optimal treatment remains undefined due to rarity and limited data.
• Median arcuate ligament (MAL) compression is consistently identified in SKS cases.

Purpose of the Study:

• To evaluate the safety and effectiveness of endovascular embolisation as a standalone treatment for SKS aneurysms.
• To assess treatment outcomes in both emergent and elective settings.
• To describe the clinical presentation and imaging findings of SKS.

Main Methods:

• A retrospective cohort study was conducted on patients treated between January 2014 and December 2021.
• Data were collected via chart review, including patient presentation, diagnostic imaging, aneurysm characteristics, CA lesion etiology, treatment details, and outcomes.
• Analysis included 14 patients with 24 identified aneurysms.

Main Results:

• Twenty-four aneurysms were identified in 14 patients; 7 out of 15 patients experienced rupture.
• The majority of aneurysms (22/24) were located in the IPDA or its branches.
• Endovascular embolisation achieved successful treatment in 6/7 ruptured aneurysms and 6/7 non-ruptured aneurysms. No recurrences were observed during a median 30-month follow-up.

Conclusions:

• Endovascular embolisation of SKS aneurysms is a safe and effective treatment modality.
• Treatment success was achieved in both emergent and elective scenarios, irrespective of concurrent MAL compression management.
• This approach offers a viable option for managing SKS aneurysms.