Transcatheter Coil Embolization of an Arc of Buhler Aneurysm

Abstract

We report the findings of a patient with an asymptomatic Arc of Buhler (AOB) aneurysm, which was successfully treated by transcatheter coil embolization. An abdominal CT and angiography revealed an intact pancreaticoduodenal artery arcade (PDAA) and an anomalous communication between the SMA and celiac axis, termed an AOB. An aneurysm was observed at the origin of the AOB and treated with a transcatheter embolization using coils. A follow-up CT imaging confirmed the total occlusion of the aneurysm with a patent PDAA. The successful results of this treatment suggest that the endovascular therapy of an AOB aneurysm with a celiac axis occlusion and an intact PDAA is feasible and safe.

The arc of Buhler: special considerations when performing pancreaticoduodenectomy

“… Tokura (2002) [ 15 ] PDA aneurysm n = 1 TAE Saad (2005) [ 9 ] Liver transplant donors n = 4 n.a. Dubel (2007) [ 4 ] AOB aneurysm n = 1 TAE Jeong (2008) [ 5 ] AOB aneurysm n = 1 TAE Kallamadi (2009) [ 6 ] Mesenteric ischemia n = 1 n.a. Jayia (2011) [ 16 ] AOB aneurysm n = 1 TAE Rusu (2011) [ 17 ] n.a.…”

Vascular Anomalies in Pancreaticoduodenectomy: A Lesson Learned

“…There are reports describing celiac obstruction by an AOB aneurysm treated successfully with coil embolization [ 12 , 13 ]. There have also been reports that describe an AOB with occlusion or high-grade stenosis of the celiac axis [ 11 , 13 – 17 ]. AOB was found in one patient with SMA occlusion [ 11 ].…”

“…AOB was found in one patient with SMA occlusion [ 11 ]. Only one other case report found MALS to be the culprit for celiac stenosis in the setting of an AOB [ 13 ] while others reported coincidence of celiac stenosis with development of aneurysms [ 1 , 17 – 19 ].…”

Acute Nonvariceal Gastrointestinal Bleeding: A Comprehensive Review and Approach for an Interventional Radiologist

“…Arc of Buhler is a standalone persistent embryological anastomotic connection between celiac and SMA, failing to regress. 18 4. Arc of Barkow is an omental collateral connection between terminal branches of the right gastroepiploic artery (branch of gastroduodenal) and the left gastroepiploic artery (branches of the splenic artery) 18 (►Fig.…”

“…18 4. Arc of Barkow is an omental collateral connection between terminal branches of the right gastroepiploic artery (branch of gastroduodenal) and the left gastroepiploic artery (branches of the splenic artery) 18 (►Fig. 4).…”