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Intravascular Ultrasound-Guided Stenting of the Celiac Artery for Hepatic Hypoperfusion After Acute Type A Aortic

Hailey B Shoemaker1, Aldin Malkoc2, Amira Barmanwalla2

  • 1Surgery, Kaiser Permanente Bernard J Tyson School of Medicine, Pasadena, USA.

Cureus
|June 19, 2024
PubMed

Insights

Type A aortic dissection can cause celiac artery occlusion, leading to liver damage. Endovascular stenting successfully restored liver blood flow in a patient, preventing hepatic failure after aortic repair.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Interventional Radiology

Background:

  • Type A aortic dissection is a critical condition necessitating immediate surgical intervention.
  • Postoperative complications, such as aortic branch occlusion and end-organ damage, can arise from the dissection and surgical procedures like cardiopulmonary bypass.
  • Celiac artery occlusion, leading to hepatic malperfusion, is a significant feared complication requiring urgent management.

Observation:

  • A 39-year-old female with hypertension developed celiac artery dissection and impending hepatic failure within 48 hours of ascending aortic replacement for Type A aortic dissection.
  • The patient presented with signs of liver compromise following the aortic repair surgery.

Findings:

  • An ultrasound-guided endovascular stent was successfully placed in the celiac artery.
  • This intervention led to prompt reperfusion of the liver, resolving the hepatic malperfusion.

Implications:

  • This case highlights a novel endovascular approach for managing celiac artery dissection complicating Type A aortic dissection.
  • Successful stenting can prevent fatal end-organ damage and offers a life-saving treatment option.
  • Further research into optimal management strategies for this specific complication is warranted.

Keywords:
celiac artery dissectionceliac artery stenthepatic malperfusiontype a aortic dissectionultrasound-guided stent placement

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