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Celiac Artery Dissection and Retroperitoneal Hemorrhage in Median Arcuate Ligament Syndrome Treated With a Stent and Transcatheter Arterial Embolization: Preprocedural 4-Dimensional Computed Tomography Angiography Assessment
- Source :
- Vascular and Endovascular Surgery. 56:75-79
- Publication Year :
- 2021
- Publisher :
- SAGE Publications, 2021.
-
Abstract
- A 61-year-old man presented with retroperitoneal hemorrhage caused by an aneurysm rupture of the pancreaticoduodenal arcade (PDA), and acute celiac artery dissection distal to celiac axis stenosis. Owing to the gradual growth of the false lumen, we planned to deploy a stent to the celiac artery dissection and embolize the PDA aneurysm. Prior to stent placement, we assessed the acute celiac artery dissection distal to the stenosis using four-dimensional computed tomography (CT) angiography through expiration/inspiration/expiration cycle. We diagnosed median arcuate ligament syndrome considering that the celiac axis showed a hooked narrowing at end-expiration, and the compression decreased at end-inspiration. Additionally, the true lumen distal to the stretched axis dilated in the inspiration phase. Therefore, we could advance a catheter into the true lumen during inspiration and successfully deploy a stent. Subsequently, laparoscopic median arcuate ligament release was performed after the stent deployment. A postoperative CT scan showed good patency in the stent, with disappearance of the blood filling the false lumen and with reduced celiac axis stenosis.
- Subjects :
- Male
medicine.medical_specialty
Computed Tomography Angiography
medicine.medical_treatment
Lumen (anatomy)
Hemorrhage
Dissection (medical)
Aneurysm, Ruptured
Median Arcuate Ligament Syndrome
Celiac Artery
Celiac artery
medicine.artery
medicine
Humans
Pancreas
medicine.diagnostic_test
business.industry
Dissection
Median arcuate ligament
Angiography
nutritional and metabolic diseases
Stent
General Medicine
Middle Aged
medicine.disease
Embolization, Therapeutic
Stenosis
Treatment Outcome
medicine.anatomical_structure
Stents
Surgery
Radiology
Tomography, X-Ray Computed
Cardiology and Cardiovascular Medicine
business
Median arcuate ligament syndrome
Subjects
Details
- ISSN :
- 19389116 and 15385744
- Volume :
- 56
- Database :
- OpenAIRE
- Journal :
- Vascular and Endovascular Surgery
- Accession number :
- edsair.doi.dedup.....e9bad4084afac127c59e0173639ad596