A giant true aneurysm of the celiac trunk

Abstract

A 80-year-old man was admitted to our department because of an arterial dilatation into the abdomen recorded during a routine ultrasound scan. His medical history was notable for smoking, chronic obstructive pulmonary disease, hypertension, hypercholesterolemia, and atrial fibrillation in anticoagulant therapy. The patient never underwent abdominal surgery and he was asymptomatic for abdominal pain.Axial (A) and lateral coronal plane (B) and volume-rendered computed tomography (CT) angiography (C) showed a giant true aneurysm of the celiac trunk. The maximum diameter was 9.4 cm. No signs of aneurysmal rupture and no bowel ischemic lesions were documented on CT scan examinations. Furthermore, no significant stenoses of the celiac arteries were detected.The patient underwent an endovascular procedure. Under local anesthesia through the right femoral artery, two covered stents were inserted and deployed (Advanta V12; Atrium Medical Corporation, Hudson, NH; 8 ϫ 59 and 7 ϫ 22 mm). The giant aneurysm was successfully excluded from the blood flow and the patient was discharged on the third postoperative day.Visceral artery aneurysms are rare vascular lesions and, among the visceral arteries, the celiac trunk is an uncommon localization (about 5%). 1 Giant aneurysms of the celiac arteries are often associated with atherosclerotic occlusive disease. 2 In our case, the giant aneurysm was not associated with occlusive disease and it was not consequent to traumatic events or previous abdominal surgery. We preferred the endovascular approach in order to reduce the perioperative risks. 3 REFERENCES 1. Stanley JC, Wakefield TW, Graham LM, Whitehouse WM Jr, Zelenock GB, Lindenauer SM. Clinical importance and management of splanchnic artery aneurysms. J Vasc Surg 1986;3:836-40. 2. D'Ayala M, Deitch JS, deGraft-Johnson J, Nguyen E, McGagh D, Gwertzman GA, et al. Giant celiac artery aneurysm with associated visceral occlusive disease. Vascular 2004;12: 390-93. 3. Tulsyan N, Kashyap VS, Greenberg RK, Sarac TP, Clair DG, Pierce G, et al. The endovascular management of visceral artery aneurysms and pseudoaneurysms. J Vasc Surg