Open surgical repair using a reimplantation technique for a large celiac artery aneurysm anomalously arising from the celiomesenteric trunk

Higashiyama, Hiroshi; Yamagami, Keiko; Fujimoto, Koji; Koshiba, Takatomo; Kumada, Kaoru; Yamamoto, Masayuki

doi:10.1016/j.jvs.2011.05.015

Cited by 13 publications

(13 citation statements)

References 17 publications

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“…Obuchi et al [12] and Wei et al [2] believed that, for aneurysms greater than 5 cm, or with a wide neck, or in the vicinity of hepatic artery or celiac trunk, interventional therapy is very difficult and tend to cause complications. In these cases, traditional open surgery, consisting of aneurysmectomy and vascular reconstruction, are the treatment of choice because they relatively safe and reliable in these cases [4,[18][19][20] .…”

Section: Discussionmentioning

confidence: 99%

Aneurysm resection and vascular reconstruction for true aneurysm at the initial segment of splenic artery

Chun-xi

Han

Liang

et al. 2015

J. Huazhong Univ. Sci. Technol. [Med. Sci.]

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The aneurysms at the initial segment of splenic artery are rare. This paper aimed to investigate the methods to treat the true aneurysm at the initial segment of splenic artery by aneurysmectomy plus vascular reconstruction. Retrospectively reviewed were 11 cases of true aneurysm at the initial segment of splenic artery who were treated in our hospital from January 2000 to June 2013. All cases were diagnosed by color ultrasonography, computer tomography (CT) and angiography. Upon resection of the aneurysm, the auto-vein transplantation was performed in situ between the hepatic artery and the distal part of the splenic artery in 1 case; the artificial vessel bypass was done between the infra-renal aorta and distal portion of the splenic artery in 7 cases; the splenectomy was done in 2 cases; the splenectomy in combination with ligation of multiple small aneurysms were performed in 1 case. All cases were cured and discharged from the hospital 10-14 days after operation. A 1-14 year follow-up showed that 9 cases survived, and 2 cases died, including 1 case who died of acute myocardial infarction 2 years after aorta-splenic artery bypass operation and 1 case who died of acute cerebral hemorrhage 5 years after aneurysm resection and the splenectomy. Among 6 cases receiving aorta-splenic artery bypass, 1 gradually developed stenosis at anatomosed site, which eventually progressed to complete occlusion 2 years to 6 years after operation, without suffering from splenic infarction because the spleen was supplied by the short gastric vessel and its collaterals. The other 5 cases receiving aorta-splenic artery bypass and 1 case undergoing autologous vascular transplantation did not develop stricture or pseudoaneurysm at the stoma. Our study showed that the aneurysmectomy plus vascular reconstruction is a better treatment for aneurysm at the initial segment of splenic artery.

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Section: Discussionmentioning

confidence: 99%

Aneurysm resection and vascular reconstruction for true aneurysm at the initial segment of splenic artery

Chun-xi

Han

Liang

et al. 2015

J. Huazhong Univ. Sci. Technol. [Med. Sci.]

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“…It is natural that the celiomesenteric trunk could become stricture or dilated as other celiac arteries [1,2]. It is very rare for an aneurysm to occur in celiomesenteric trunk as the incidence of such coexistence trunk is less than 1% of celiac arterial deformities, while the celiac trunk and superior mesenteric artery (SMA) are involved in less than 10% of all visceral aneurysms [5,6,9]. The reason for celiomesenteric trunk aneurysm occurrence is not clear, which might be related to abnormal embryologic development and the arterial degeneration.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the open operation (including the aneurysm excision, aortic-superior mesenteric artery bypass, aortic-hepatic artery bypass, aortic-splenic artery bypass) actually becomes the chief therapy at present [15]. However, it is very difficult to do such operation as most of aneurysm body hides behind pancreas and next to stomach, spleen and other retroperitoneal organs [5,6,16]. To ensure the vascular reconstruction safety, the aneurysm neck is exposed and controlled effectively.…”

Section: Discussionmentioning

confidence: 99%

“…Because of its rarity, few lesions of the celiomesenteric trunk have been reported [1,2]. Although the visceral aneurysms were sometimes reported [3][4][5], it is very rare to report the malformed celiomesenteric trunk aneurysm as it only accounts for less than 1% of all celiac artery anomalies [6]. The malformed celiomesenteric aneurysm contains an odd structure which makes hepatic artery, splenic artery, left gastric artery and mesenteric artery come from the same aneurysm rather than from aorta or celiac trunk.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, such special anatomic structure makes therapeutic procedure complicated. Surgical intervention for this condition is challenging [5,6] when the aneurysm is larger or almost occupies the whole trunk, especially in the back of pancreas. The reason is that the hepatic artery, splenic artery, mesenteric artery, and left gastric artery have to be reconstructed once the malformed aneurysm has been cut off.…”

Section: Introductionmentioning

confidence: 99%

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Surgical treatment of celiomesenteric trunk aneurysm-7 case report

Wang¹,

Cai

Liang³

et al. 2014

Bio-Medical Materials and Engineering

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The celiomesenteric trunk is a rare anomaly characterized by a common origin of the celiac axis and superior mesenteric artery from the aorta, which accounts for less than 1% of all celiac artery anomalies, so the aneurysm occurred in such trunk is even rarer. There have been few reports on how to diagnose and deal with such malformed celiomesenteric trunk aneurysms till now. This paper tries to summarize the experience of how to expose and excise such kind of aneurysm according to the seven cases' data. The clinic data were collected retrospectively. There were seven cases with celiomesenteric trunk aneurysm from February 2000 to February 2013, including 5 males and 2 females aged 35~62. The operations were done including aneurysm resection and vascular reconstruction under general anesthesia. The operated patients were followed-up at the sixth month and each year post operation. The vascular stomas were detected or examined by Color Doppler Sonography, spiral Computed Tomography angiography (SCTA). The seven operated patients were cured and discharged from hospital, and they were followed up for 3~10 years (mean time 5 years), with four patients being followed up longer than 5 years. No sign of intestinal ischemia or hepatic ischemia or splenic ischemia was found, and no image of anastomosis stricture or stenosis was found during the follow-up. Five patients are alive now while two patients were dead, with one dying of large area myocardial infarction unexpectedly at 6 years post operation and the other dying of cerebral infarction abruptly at 4 years post operation. It is an effective and safe method to treat the celiomesenteric trunk aneurysm by using by-pass operation with artificial blood vessels, originating from inferior kidney aorta to visceral arteries including hepatic artery, splenic artery and superior mesenteric artery. Its short-term and middle-term effects are relatively better.

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Dissecting Aneurysm of the Hepatic Artery Caused by an Isolated Spontaneous Celiac Trunk Dissection

Higashiyama

Imamura

Fujimoto

et al. 2014

Annals of Vascular Surgery

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Open surgical repair using a reimplantation technique for a large celiac artery aneurysm anomalously arising from the celiomesenteric trunk

Cited by 13 publications

References 17 publications

Aneurysm resection and vascular reconstruction for true aneurysm at the initial segment of splenic artery

Aneurysm resection and vascular reconstruction for true aneurysm at the initial segment of splenic artery

Surgical treatment of celiomesenteric trunk aneurysm-7 case report

Dissecting Aneurysm of the Hepatic Artery Caused by an Isolated Spontaneous Celiac Trunk Dissection

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