Successful stent-assisted coiling of celiac trunk aneurysms. A case series.

Zielsetzung To present the first case series of successful stent-assisted coiling of three celiac trunk (CT) pseudoaneurysms. CT aneurysms and pseudoaneuryms are rare but potentially serious clinical conditions. As most patients are asymptomatic, aneurysms are usually detected incidentally. Treatment can be either surgical or endovascular. Reported endovascular repairs include CT occlusion or stent-grafting, if necessary supported by coil or glue embolization. (1-4). Disadvantages include the occlusion of branch arteries such as the left gastric artery (left accessory/replaced hepatic artery), inferior phrenic arteriesand/or splenic artery and dependence on good collateralization.

Material und Methoden Between January and July 2021 three patients received endovascular treatment for unruptured dissecting aneurysms of the CT. Two patients had been diagnosed as incidental findings during diagnostic imaging. One patient showed a pseudoaneurysm due to a periceliac aortic dissection. Mean age was 63.7 years. Aneurysm diameter ranged from 15-24 mm. No patient showed any symptoms. All three cases were treated with stent-assisted coiling. An oversized self-expanding LifeStent (Bard Peripheral Vascular, Tempe, USA) was implanted into the hepatic artery up to the celiac trunk, with protrusion into the aorta. The aneurysms were then occluded in coaxial technique with detachable coils. No periprocedural complications occurred. All patients received DAPT for 4-8 weeks and ASS monotherapy thereafter.

Ergebnisse 3- and 6-month follow-up showed aneurysm occlusion and patent stents and CT-branches in all patients. No coil migration occurred.

Schlußfolgerungen Our cases show that minimally invasive stent-assisted coiling in coaxial technique is a feasible and effective approach to celiac trunk aneurysms and pseudoaneurysms.

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Artikel online veröffentlicht:
29. August 2022