Calcified pancreatoduodenal artery aneurysm with filiform celiac stenosis: Follow up for ~6 years (70 months) with no intervention

Zhanar Kozhakhmetova 1, Ulugbek Alimov 2, Galymzhan Kuatbay 3 *
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1 Department of Radiology, Astana Medical University, Astana, Kazakhstan
2 Department of Diagnostic Radiology, Multifunctional City Hospital No 2, Astana, Kazakhstan
3 Department of Internal Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan
* Corresponding Author
J CLIN MED KAZ, Volume 19, Issue 5, pp. 51-54. https://doi.org/10.23950/jcmk/12550
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ABSTRACT

A 72-year-old male patient was investigated with abdominal ultrasound (US) imaging before the coronary artery bypass graft surgery (CABG). The incidental finding on ultrasound was an aneurysm of the superior mesenteric artery branch. Consequent CT angiography confirmed aneurysm of the inferior pancreaticoduodenal artery (PDAA, size = 25,5x31,0x28,5mm) with filiform celiac artery stenosis. According to the European Guideline asymptomatic >25mm sized PDAA are treated with an urgent repair. However, the discrepancy between PDAA size and risk of rupture and individual parameters of the patient led the multifunctional team to assign regular follow-ups with US imaging. This case report describes rare pathology, which has been followed up for the last ~6 years (70 months) annually with no intervention, and discusses complexities in making decisions in the management of PDAA with celiac artery stenosis.
Keywords: pancreatoduodenal artery aneurysm, celiac artery stenosis, visceral artery aneurysm, rare cases

CITATION

Kozhakhmetova Z, Alimov U, Kuatbay G. Calcified pancreatoduodenal artery aneurysm with filiform celiac stenosis: Follow up for ~6 years (70 months) with no intervention. J CLIN MED KAZ. 2022;19(5):51-4. https://doi.org/10.23950/jcmk/12550

REFERENCES

  • Moore E, Matthews MR, Minion DJ, Quick R, Schwarcz TH, Loh FK, et al. Surgical management of peripancreatic arterial aneurysms. J Vasc Surg. 2004;40:247–53. https://doi.org/10.1016/j.jvs.2004.03.045
  • Kalva, S. P., Athanasoulis, C. A., Greenfield, A. J., Fan, C. M., Curvelo, M., Waltman, A. C., & Wicky, S. Inferior pancreaticoduodenal artery aneurysms in association with celiac axis stenosis or occlusion. European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery. 2007; 33(6):670–675. https://doi.org/10.1016/j.ejvs.2006.12.021
  • Björck M., Koelemay, M., Acosta, S., Bastos Goncalves, F., Kölbel, T., Kolkman, J. J., Lees, T., Lefevre, J. H., Menyhei, G., Oderich, G., Esvs Guidelines Committee, Kolh, P., de Borst, G. J., Chakfe, N., Debus, S., Hinchliffe, R., Kakkos, S., Koncar, I., Sanddal Lindholt, J., Vega de Ceniga, M., Naylor, R. Editor's Choice - Management of the Diseases of Mesenteric Arteries and Veins: Clinical Practice Guidelines of the European Society of Vascular Surgery (ESVS). European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery. 2017; 53(4):460–510. https://doi.org/10.1016/j.ejvs.2017.01.010
  • Thony, F., & Rodiere, M. Epidemiology and indications for treatment of visceral artery aneurysms. Cardiovasc Intervent Radiol. 2013; 36:0174-1551.
  • Ducasse, E., Roy, F., Chevalier, J., Massouille, D., Smith, M., Speziale, F., Fiorani, P., & Puppinck, P. Aneurysm of the pancreaticoduodenal arteries with a celiac trunk lesion: current management. Journal of vascular surgery. 2004; 39(4):906–911. https://doi.org/10.1016/j.jvs.2003.09.049
  • Yoon, H. J., Choi, J. S., Shin, W. Y., Lee, K. Y., & Ahn, S. I. (2020). Causal Relationship between Celiac Stenosis and Pancreaticoduodenal Artery Aneurysm: Interpretation by Simulation Using an Electric Circuit. BioMed research international. 2020; 2738726. https://doi.org/10.1155/2020/2738726
  • Vandy, F. C., Sell, K. A., Eliason, J. L., Coleman, D. M., Rectenwald, J. E., & Stanley, J. C. Pancreaticoduodenal and Gastroduodenal Artery Aneurysms Associated with Celiac Artery Occlusive Disease. Annals of vascular surgery. 2017; 41:32–40. https://doi.org/10.1016/j.avsg.2016.09.018
  • Kallamadi, R., Demoya, M. A., & Kalva, S. P. Inferior pancreaticoduodenal artery aneurysms in association with celiac stenosis/occlusion. Seminars in interventional radiology. 2009; 26(3):215–223. https://doi.org/10.1055/s-0029-1225671
  • Takao, H., Doi, I., Watanabe, T., Yoshioka, N., & Ohtomo, K. Natural history of true pancreaticoduodenal artery aneurysms. The British journal of radiology. 2010; 83(993):744–746. https://doi.org/10.1259/bjr/17700576
  • Obara, H., Kentaro, M., Inoue, M., & Kitagawa, Y. Current management strategies for visceral artery aneurysms: an overview. Surgery today. 2020; 50(1):38–49. https://doi.org/10.1007/s00595-019-01898-3