Pancreaticoduodenal Artery Aneurysm Complicated by Median Arcuate Ligament Syndrome.

IF 0.7 4区医学 Q4 PERIPHERAL VASCULAR DISEASE

Vascular and Endovascular Surgery Pub Date : 2024-02-01 Epub Date: 2023-08-27 DOI:10.1177/15385744231198934

Sean Hamlin, Stephen R Gallo, Jameson Petrochko, Jacob Wilson, Sharvil Sheth

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引用次数: 0

Abstract

Purpose: To highlight median arcuate ligament syndrome as a potential cause for celiac artery stenosis and pancreaticoduodenal artery aneurysm, and describe treatment options in this setting.

Case report: A 63-year-old male presented with a pancreaticoduodenal artery aneurysm and concomitant celiac artery stenosis that was treated with celiac artery stenting and aneurysm coiling. He subsequently developed stent fracture and celiac artery occlusion secondary to previously unrecognized median arcuate ligament syndrome causing reperfusion of the aneurysm. This was treated with open median arcuate ligament release and aorta to common hepatic artery bypass with good clinical result and stable 20-month surveillance imaging.

Conclusion: It is critical to recognize median arcuate ligament syndrome as a cause of celiac artery stenosis in the setting of pancreaticoduodenal artery aneurysm given the high risk of failure of endovascular stenting. Open aorto-hepatic artery bypass and endovascular aneurysm coiling should be the preferred approach in these patients.

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胰十二指肠动脉瘤并发正中弓形韧带综合征

目的：强调正中弓形韧带综合征是腹腔动脉狭窄和胰十二指肠动脉瘤的潜在病因，并描述这种情况下的治疗方案：一名 63 岁的男性患有胰十二指肠动脉瘤，同时伴有腹腔动脉狭窄，曾接受腹腔动脉支架和动脉瘤卷绕术治疗。随后，他出现了支架断裂和腹腔动脉闭塞，继发于之前未被发现的正中弓状韧带综合征，导致动脉瘤再灌注。经开放性弓状内韧带松解术和主动脉至肝总动脉搭桥术治疗后，临床效果良好，20 个月的监测造影结果稳定：结论：鉴于血管内支架治疗失败的风险很高，因此在胰十二指肠动脉瘤的情况下，将弓状韧带综合征视为腹腔动脉狭窄的病因至关重要。这些患者应首选开放式肝主动脉搭桥术和血管内动脉瘤夹闭术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vascular and Endovascular Surgery SURGERY-PERIPHERAL VASCULAR DISEASE

CiteScore

1.70

自引率

11.10%

发文量

132

审稿时长

4-8 weeks

期刊介绍： Vascular and Endovascular Surgery (VES) is a peer-reviewed journal that publishes information to guide vascular specialists in endovascular, surgical, and medical treatment of vascular disease. VES contains original scientific articles on vascular intervention, including new endovascular therapies for peripheral artery, aneurysm, carotid, and venous conditions. This journal is a member of the Committee on Publication Ethics (COPE).