Natural course of incidentally detected isolated Celiac Artery Dissection with hepatic artery occlusion

Duraikannu, Chary; Karunakaran, Parthasarathy; Haithrous, Shamim Ahamed; Pulupula, Venkata Narasimha Kumar

doi:10.1016/j.radcr.2020.01.028

Cited by 2 publications

(4 citation statements)

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“…After reading the full texts, 18 studies were excluded further as displayed in Figure 1. Eventually, 60 reports (53 case reports [2,3,16–66] and 7 case series [7,11,67–71] ) with 125 ICAD patients were included for detailed information in analysis. According to our definition of age group, 62 cases were young patients and 63 cases were considered as old patients.…”

Section: Resultsmentioning

confidence: 99%

“…According to the present study, the majority of ICAD patients received conservative treatment, but some need endovascular treatment or open surgery because of arterial rupture and hemorrhagic shock, rupture of the aneurysm. [ 18 , 24 , 25 ] Given the rare previous reports included small numbers of patients, and data on its etiology, clinical features, management, hospital course, and outcomes were scarce. Spontaneous IVAD was reportedly observed in middle-aged men with comorbidities, such as hypertension and smoking, [ 75 , 76 ] suggesting that IVAD might be associated with this factors.…”

Section: Discussionmentioning

confidence: 99%

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The characteristics and comparison between young and old patients with spontaneous isolated celiac artery dissection: Analysis based on 60 reports

Chen,

Wu,

Wang

et al. 2023

Medicine

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Background and aims: Though increasing studies reported the management of spontaneous isolated celiac artery dissection (ICAD), the characteristics and etiology of ICAD in different age-stage patients have not been well-studied. Our study was designed to describe and further to compare the clinical features of spontaneous ICAD between young and old patients. Methods: We searched PubMed, Embase, and Web of Science up to March 1, 2023 for spontaneous ICAD case reports. Two reviewers screened the titles and abstracts of searched records for qualified reports according to the including and excluding criteria and extracted the data independently. Statistical analysis was performed using SPSS software (version 19.0; IBM Corp, Armonk, NY) and Stata 12.0 (Stata Corp., College Station, TX). Descriptive results were presented as the mean ± standard deviation or percent. The comparison results between young and old patients were displayed as risk ratio (RR) or standardized mean difference (SMD) with its 95% confidence intervals (CI). Results: We totally identified 60 reports in the present analysis. The mean age of patients was 52.4 years, with the majority of patients being male (84.4%). The majority of patients were symptomatic and commonest presentation was abdominal pain (76.7%). Most patients (63.2%) had comorbidities or history and hypertension and smoking were the top 2 conditions with proportion of 63.3% and 40.5% respectively. When comparing young to old patients with ICAD, no significant difference was found in demographic and clinical features including sex, comorbidities/history, and symptoms. However, we found that young patients with ICAD experienced significantly longer dissection length (SMD 1.01, 95% CI 0.16–1.86; P = .015) and distance from ostium (SMD 0.96, 95% CI 0.07–1.85; P = .013), but no significant difference was observed in true lumen compression (SMD −0.39, 95% CI −1.22–0.44; P = .364). In addition, our results showed that ICAD in young patients extending more to distal arteries, including common hepatic artery/hepatic artery (RR 2.04, 95% CI 1.13–3.68; P = .01), splenic artery (RR 2.36, 95% CI 1.24–4.49; P = .017) and left gastric artery (RR 25.42; 95% CI 1.55–417.74; P = .04). Conclusions: Though spontaneous ICAD had multitudinous clinic-pathologic features, it was apt to middle-aged males and symptomatic and abdominal pain was always the commonest presentation. Hypertension and smoking were the top 2 conditions of ICAD patients. There was significant difference between young and old patients in radiographic characteristics of ICAD which may lead to different treatment and outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The characteristics and comparison between young and old patients with spontaneous isolated celiac artery dissection: Analysis based on 60 reports

Chen,

Wu,

Wang

et al. 2023

Medicine

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“…En la revisión sistemática publicada por Cavalcante et al, el manejo fue conservador en un 79,1 %, endovascular en un 11,8 % y quirúrgico en un 8,9 % de los casos. Se ha reportado que, sin importar la morfología de la disección, la mayoría de los casos se manejan de forma conservadora con tratamiento antihipertensivo, con o sin terapia anticoagulante y antiagregante 4,[18][19][20] . La terapia anticoagulante se fundamenta en el alto riesgo de trombosis de las arterias viscerales dado su menor diámetro y flujo más lento en comparación con la aorta 21 .…”

Section: Discussionunclassified

“…La terapia anticoagulante se fundamenta en el alto riesgo de trombosis de las arterias viscerales dado su menor diámetro y flujo más lento en comparación con la aorta 21 . Sin embargo, hay reportes de manejo expectante exitoso en pacientes asintomáticos en quienes el hallazgo fue incidental 19 .…”

Section: Discussionunclassified

Disección espontánea del tronco celíaco. Una emergencia vascular inusual

et al. 2021

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Introducción. La disección espontánea del tronco o arteria celíaca es una emergencia vascular abdominal inusual, con una incidencia desconocida. Actualmente no existen guías o consensos para su tratamiento, el cual va desde intervenciones vasculares mayores hasta la conducta expectante. Caso clínico. Paciente masculino de 42 años sin antecedentes patológicos, con dolor abdominal intenso de un mes de evolución. Ante la sospecha clínica de patología inflamatoria se realizó una tomografía computarizada abdominal con medio de contraste, en la que se observó una disección del tronco celíaco asociada a un infarto esplénico. Se realizó manejo endovascular de forma exitosa. Discusión. La disección espontánea del tronco celíaco es una patología infrecuente, que puede presentarse en pacientes con hipertensión arterial, tabaquismo, enfermedad ateroesclerótica y vasculitis. Los síntomas más comunes son el dolor abdominal asociado a náuseas y vómito. La sospecha clínica debe ser confirmada mediante estudios imagenológicos que orienten al tratamiento conservador, endovascular o quirúrgico, ante la sospecha de infarto intestinal o ruptura arterial. Conclusiones. La disección espontánea del tronco celíaco es una patología vascular inusual que puede relacionarse con una alta mortalidad. Es importante tener siempre presente la interrelación entre la anatomía vascular abdominal, la anamnesis y el examen físico como elementos claves para realizar este diagnóstico.

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Natural course of incidentally detected isolated Celiac Artery Dissection with hepatic artery occlusion

Cited by 2 publications

References 25 publications

The characteristics and comparison between young and old patients with spontaneous isolated celiac artery dissection: Analysis based on 60 reports

The characteristics and comparison between young and old patients with spontaneous isolated celiac artery dissection: Analysis based on 60 reports

Disección espontánea del tronco celíaco. Una emergencia vascular inusual

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