Giant celiac artery aneurysm

Abstract

Celiac artery aneurysms (CAAs) are rare but potentially devastating lesions. Given the high rates of mortality on rupture at large sizes, they should be treated promptly with either surgical or endovascular interventions in appropriate-risk patients. Several options exist for treatment, including surgical repair and endovascular embolization with or without stent or stent graft placement. Because of their rarity, there are few reports of successfully treated CAA lesions. Herein, we describe successful endovascular treatment of one of the largest CAAs reported in the literature.

Giant Coeliac Artery Aneurysm Treated with a Hybrid Approach: A Case Report

“…Reportedly, three cases of CA aneurysms >10 cm in size have been treated with coil embolisation. 6 , 7 , 8 One was asymptomatic, 6 and the other two were symptomatic, presenting with abdominal pain 7 and post-prandial nausea. 8 The latter patient developed recurrent symptoms six weeks after the first embolisation because of recanalisation.…”

Endovascular Treatment of Giant Visceral Aneurysms: An Overview

“…Moreover, the procedure can be performed in a multistage fashion, in order to occlude the several efferent vessels progressively and reduce radiation exposure to the patient. 42 The strategy may represent a risk due to the dynamic flow and pressure change inside the sac that may lead to a sudden rupture.…”

“…Therefore, in giant-sized aneurysms, the presence or not of sac thrombus may be of paramount importance, as sufficient coil packing to prevent revascularisation would result in significant additional cost, time, and radiation exposure to the patient with equivocal overall benefit. 35,36,[42][43][44] In order to achieve a better post-coiling result, the use of the combination of liquid embolics, such as ethylene vinyl alcohol copolymer (Onyx), with coil has been reported with good results. 37 The use of covered stents, although virtually appealing for preserving the vessel patency as reported in the literature, is not feasible in most cases for dealing with GVAAs because of the absence of an optimal landing zone, significant tortuosity and evidence of an infected sac.…”