Pancreaticoduodenal artery aneurysm associated with coeliac trunk occlusion treated with aorto-hepatic bypass and aneurysm resection

Whitley, Adam; Bafrnec, Jan; Rokošný, Slavomír; Lawrie, Kateřina; Balaz, Peter

doi:10.1177/17085381211070353

Cited by 1 publication

(1 citation statement)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Various surgical approaches have been reported including ligation, resection, or endoaneurysmorraphy which are commonly combined with a division of the median arcuate ligament to treat the upstream stenosis or occlusion [ 7 ]. Excision of the aneurysm might also be combined with an aorto-hepatic bypass [ 21 ]. Both surgical and endovascular approaches are reported to produce good results even though follow-up periods might vary significantly in length [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Visceral Artery Aneurysms in the Presence of Upstream Stenoses

Hofmann,

Schuch,

Berger

et al. 2024

JCM

View full text Add to dashboard Cite

Background: Sutton–Kadir syndrome describes a rare pathology that commonly includes an aneurysm of the inferior pancreaticoduodenal artery in combination with a celiac trunk stenosis or occlusion, often caused by median arcuate ligament compression. Several therapeutic approaches exist including open surgical, endovascular, and hybrid treatments. Other combinations of visceral artery aneurysms and upstream stenoses exist but the cumulative body of evidence on these combinations is weak due to their rarity. Methods: A retrospective analysis of patient data from a single center was carried out. Electronic patient records were filtered for keywords including “visceral aneurysm”, “Sutton–Kadir”, and “median arcuate ligament”. Imaging studies were re-examined by two blinded vascular surgeons with a third vascular surgeon as a referee in case of diverging results. Results: Sixteen patients had a visceral artery aneurysm with an upstream stenosis. All cases had a celiac trunk obstruction while one patient also had a concomitant superior mesenteric artery stenosis. Both median arcuate ligament compression and atherosclerotic lesions were identified. The location of the aneurysms varied even though the inferior pancreaticoduodenal artery was most frequently affected. A classification system based on the different combinations of stenoses and aneurysms is presented and introduced as a new pathologic entity: visceral artery aneurysm in the presence of upstream stenosis (VAPUS). Conclusions: The concomitant presence of visceral artery aneurysms, especially in the pancreaticoduodenal arteries, and blood flow impairment of the celiac axis or superior mesenteric artery is a rare pathology. The proposed VAPUS classification system offers an accessible and transparent route to the precise localization of the affected vessels.

show abstract

Section: Introductionmentioning

confidence: 99%