We present a case of a hemorrhagic duodenal ulcer complicated by occlusion of the celiac artery (CA) by acute median arcuate ligament (MAL) compression. Angiography revealed retrograde flow through the gastroduodenal artery (GDA) to the hepatic artery, with occlusion at the CA origin. This unique presentation required coordinated release of the MAL to reestablish antegrade CA flow before pyloroplasty and GDA ligation. The presence of preexisting MAL compression of the CA should be considered during the repair of bleeding duodenal ulcers through embolization or ligation of the GDA, because impaired CA perfusion could result in foregut ischemia.
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http://dx.doi.org/10.1016/j.jvscit.2023.101371 | DOI Listing |
J Vasc Surg
January 2025
Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston, MA. Electronic address:
Objective: As aneurysmal disease is progressive, proximal disease progression and para-anastomotic aneurysms are complications experienced after open infrarenal abdominal aortic aneurysm repair (AAA). As such, fenestrated or branched endovascular repair (F/BEVAR) may be indicated in these patients. Data describing fenestrated endovascular aneurysm repair after prior open repair are limited to institutional databases.
View Article and Find Full Text PDFJ Vasc Surg Cases Innov Tech
April 2025
Department of Surgery, Westchester Medical Center, Valhalla, NY.
We present a case of an 86-year-old female with chronic mesenteric ischemia secondary to long-segment flush occlusion of the superior mesenteric artery and near-total occlusion of the celiac artery. The superior mesenteric artery was unable to be revascularized by conventional antegrade approaches. Successful transcollateral crossing of the occluded superior mesenteric artery and body-flossing, followed by antegrade balloon angioplasty, shockwave lithotripsy, and stent implantation were performed.
View Article and Find Full Text PDFInt J Surg Case Rep
January 2025
Karnali Academy of Health Science, Jumla, Nepal.
Introduction And Importance: Splenic artery aneurysm is extremely rare but potentially life threatening disease which poses great challenge in diagnosing due to non-specific nature of clinical presentation. Rarely, it presents with upper gastrointestinal bleeding i.e.
View Article and Find Full Text PDFEJVES Vasc Forum
November 2024
Vascular Surgery, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.
Objective: Paravisceral aortic lesions present significant challenges for endovascular treatment. This retrospective analysis of consecutively treated patients from April 2017 to June 2021 aimed to analyse the outcome of primary intra-operative embolisation of aortic complicated pseudoaneurysms and gutter channels during parallel graft (PG) repair of paravisceral symptomatic aortic pseudoaneurysms.
Methods: Patients with symptomatic pseudoaneurysms of the paravisceral aorta treated with PGs using chimney or periscope configurations were included.
J Endovasc Ther
January 2025
Vascular Unit, Department of Surgery, Mater Dei Hospital, Msida, Malta.
Purpose: The use of surgeon-modified fenestrated endograft to treat a bleeding complication in the common iliac artery.
Technique: An Endurant limb graft was modified on back table in theater after planning the fenestration using a semi-automated centerline. The Endurant stent was planned to land flush at the aortic bifurcation.
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