Common celiacomesenteric trunk: Aneurysmal and occlusive disease

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Presentation transcript:

Common celiacomesenteric trunk: Aneurysmal and occlusive disease Gorav Ailawadi, MD, Robert A. Cowles, MD, James C. Stanley, MD, Jonathan L. Eliason, MD, David M. Williams, MD, Lisa M. Colletti, MD, Peter K. Henke, MD, Gilbert R. Upchurch, MD Journal of Vascular Surgery Volume 40, Issue 5, Pages 1040-1043 (November 2004) DOI: 10.1016/j.jvs.2004.08.028 Copyright © 2004 The Society for Vascular Surgery Terms and Conditions

Fig 1 A, Lateral aortogram demonstrates an occluded celiacomensenteric trunk (CMT; arrow). B, Aortogram after aorto-CMT bypass with polytetrafluoroethylene graft (arrow) demonstrates antegrade filling of CMT. C, Selective arteriogram of graft reveals hepatic, splenic, and superior mesenteric artery branches (arrows) arising from CMT. Journal of Vascular Surgery 2004 40, 1040-1043DOI: (10.1016/j.jvs.2004.08.028) Copyright © 2004 The Society for Vascular Surgery Terms and Conditions

Fig 2 A, Initial lateral arteriogram reveals a celiacomensenteric trunk (CMT; black arrow) originating from a tortuous abdominal aorta (white arrows). B, Selective CMT injection reveals a large CMT aneurysm (black arrows) and exiting celiac and superior mesenteric arteries (white arrows). C, Postoperative aortogram demonstrates replacement of the tortuous aorta with a polytetrafluoroethylene interposition graft and a patent polytetrafluoroethylene aorto-CMT bypass (black arrows) with celiac and superior mesenteric branches (white arrows). Journal of Vascular Surgery 2004 40, 1040-1043DOI: (10.1016/j.jvs.2004.08.028) Copyright © 2004 The Society for Vascular Surgery Terms and Conditions

Fig 3 A, Aortogram demonstrates aortic dissection with a stent in the true lumen (white arrows) and poor filling of the celiacomensenteric trunk (black arrow) from the false lumen. B, After endovascular fenestration of the septum between the true and false lumens, improved flow through the celiacomensenteric trunk is evident (black arrow). Journal of Vascular Surgery 2004 40, 1040-1043DOI: (10.1016/j.jvs.2004.08.028) Copyright © 2004 The Society for Vascular Surgery Terms and Conditions

Fig 4 A, Illustration of dorsal aorta, ventral segmental roots 10 through 13, and longitudinal anastomosis at 4 to 7 weeks of fetal development. B, Normal development in adult splanchnic vessels after regression of roots 11 and 12, and the longitudinal anastomosis; the celiac artery (CA) and superior mesenteric artery (SMA) are derived from roots 10 and 13, respectively. C, Celiacomesenteric variant with development of a celiacomensenteric trunk (CMT) follows regression of roots 10, 11, and 12, with persistence of the longitudinal anastomosis. CA, Celiac artery; SMA, superior mesenteric artery. Journal of Vascular Surgery 2004 40, 1040-1043DOI: (10.1016/j.jvs.2004.08.028) Copyright © 2004 The Society for Vascular Surgery Terms and Conditions