Preprint Article Version 1 This version is not peer-reviewed

Is Celiac Trunk Revascularization Necessary after High-Flow Pancreaticoduodenal Arterial Arcades Aneurysm Retrograde Embolization?

Mohamed Salim Jazzar
,
Hicham Kobeiter
,
Mario Ghosn
,
Raphael Amar
,
Youssef Zaarour
,
Athena Galletto Pregliasco
,
Pascal Desgranges
,
Vania Tacher
,
Mostafa El Hajjam
,
Haytham Derbel
*
Version 1 : Received: 14 October 2024 / Approved: 14 October 2024 / Online: 15 October 2024 (09:45:33 CEST)

How to cite: Jazzar, M. S.; Kobeiter, H.; Ghosn, M.; Amar, R.; Zaarour, Y.; Galletto Pregliasco, A.; Desgranges, P.; Tacher, V.; El Hajjam, M.; Derbel, H. Is Celiac Trunk Revascularization Necessary after High-Flow Pancreaticoduodenal Arterial Arcades Aneurysm Retrograde Embolization?. Preprints 2024, 2024101127. https://doi.org/10.20944/preprints202410.1127.v1 Jazzar, M. S.; Kobeiter, H.; Ghosn, M.; Amar, R.; Zaarour, Y.; Galletto Pregliasco, A.; Desgranges, P.; Tacher, V.; El Hajjam, M.; Derbel, H. Is Celiac Trunk Revascularization Necessary after High-Flow Pancreaticoduodenal Arterial Arcades Aneurysm Retrograde Embolization?. Preprints 2024, 2024101127. https://doi.org/10.20944/preprints202410.1127.v1

Abstract

Background: High-flow pancreaticoduodenal artery (PDA) aneurysms secondary to celiac trunk occlusion or stenosis have a high risk of rupture. Embolization offers a less invasive alternative to surgery. Objective: To evaluate the effectiveness and safety of retrograde embolization via the superior mesenteric artery of high-flow PDA aneurysms without celiac trunk revascularization. Methods: This retrospective bicentric study included patients who underwent embolization of high-flow PDA aneurysms due to significant celiac trunk stenosis or occlusion. All patients underwent pre-interventional dynamic contrast-enhanced computed tomography. Retrograde embolization was performed using microcoils and/or liquid agents without celiac trunk revascularization. Follow-up involved clinical and radiological assessment at one month. Technical and clinical success were evaluated, and complications were categorized as minor or major. Results: Twenty-three patients (mean age: 65 ±14 years; 52% male) were included. Emergency embolization was required in 12 patients (52%). The technical success rate was 100%. Patients were monitored for a median of 16 months. Clinical success was 87%. No hemorrhagic recurrences were observed. Minor complications occurred in two cases. One major complication involved splenic infarction due to glue migration, requiring splenectomy and intensive unit care admission. Conclusion: Retrograde embolization of high-flow PDA aneurysms is effective and safe without needing celiac trunk revascularization.

Keywords

Mesenteric artery, superior; Radiology, Interventional; Aneurysm, Ruptured; Hemorrhage; Angiography

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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