Vladimir Neychev, MD, PhD, Emilia Krol, MD, Alan Dietzek, MD

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Presentation transcript:

Unusual presentation and treatment of spontaneous celiac artery dissection Vladimir Neychev, MD, PhD, Emilia Krol, MD, Alan Dietzek, MD Journal of Vascular Surgery Volume 58, Issue 2, Pages 491-495 (August 2013) DOI: 10.1016/j.jvs.2012.10.136 Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 1 Preoperative computed tomography (CT) cross-sections in (A) axial and (B) sagittal views demonstrate the “double-lumen” sign (black arrows) of the dissecting celiac artery aneurysm with free fluid in the lesser sac (white arrows) consistent with hemorrhage. A celiac artery angiogram in (C) anterior and (D) lateral views demonstrates dissection and aneurysmal dilatation of the celiac artery extending to the common hepatic and splenic arteries. Journal of Vascular Surgery 2013 58, 491-495DOI: (10.1016/j.jvs.2012.10.136) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 2 An angiogram of the splenic artery reveals (A) aneurysmal dilatation and long dissection of the artery and (B) coil embolization. C, Shows angiogram of the left gastric artery visualized posterior to coiled splenic artery, (D) single-coil embolization of the left gastric artery, and (E) deployment of the stent graft just proximal to the origin of the gastroduodenal artery and extending to the orifice of the celiac artery. F, A completion angiogram demonstrates good flow into the gastroduodenal and hepatic arteries and no flow into the aneurysm sac. Journal of Vascular Surgery 2013 58, 491-495DOI: (10.1016/j.jvs.2012.10.136) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 3 A follow-up duplex ultrasound image at 3 months demonstrates (A) celiac-hepatic artery stent graft, (B) continued aneurysm exclusion with no evidence of endoleak, (C) patent hepatic and gastroduodenal arteries. The ultrasound cursor is in the common hepatic artery. Journal of Vascular Surgery 2013 58, 491-495DOI: (10.1016/j.jvs.2012.10.136) Copyright © 2013 Society for Vascular Surgery Terms and Conditions