Celiac Artery Aneurysm Due to Chronic Spontaneous Dissection: Two Cases of Surgical Repair

Daisuke Fukui^*, Yuko Wada, Yoshinori Ohtsu, Kazunori Komatsu, Noburo Ohashi, Ko Nakahara, Toshihito Gomibuchi, Tatsuichiro Seto, Kenji Okada

Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.

DOI: 10.4236/wjcd.2015.52004                

Abstract

In this report, we describe two surgical cases of celiac artery aneurysm due to chronic and asymptomatic spontaneous dissection without atherosclerotic change or medial degeneration. Case 1 had replacement of the celiac and common hepatic arteries using a knitted Dacron prosthetic graft, and case 2 had simple aneurysmectomy. The incidence of celiac artery dissection is increasing lately, but subsequent aneurysm is relatively rare. Our two cases had no atherosclerotic risk factors, so it might be possible that celiac artery aneurysm due to spontaneous dissection may produce different findings from dissection of other arteries. We consider that the need for surgery should be determined carefully if the asymptomatic celiac artery aneurysm due to dissection is small and unless it shows any changes in its diameter in the follow-up period.

Keywords

Celiac Artery Aneurysm, Spontaneous Dissection, Surgical Repair

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Bret, P.M., Partensky, C., Bretagnolle, M., Paliard, P. and Burke, M. (1987) Obstructive Jaundice by a Dissecting Aneurysm of Celiac Axis and Hepatic Artery. Digestive Diseases and Sciences, 32, 1431-1434. http://dx.doi.org/10.1007/BF01296672
[2]	Bartoli, J.M., Moulin, G., Di Stefano, D., Rudondy, P., Gerolami, A. and Kasbarian, M. (1990) Isolated Dissection of the Celiac Trunk and Its Branches. X-Ray Computed Tomography and Angiography Findings. A Case Report. Annales de Radiologie, 33, 264-266.
[3]	Takeda, H., Matsunaga, N., Sakamoto, I., Obata, S., Nakamura, S. and Hayashi, K. (1995) Spontaneous Dissection of the Celiac and Hepatic Arteries Treated by Transcatheter Embolization. American Journal of Roentgenology, 165, 1288-1289. http://dx.doi.org/10.2214/ajr.165.5.7572520
[4]	Chaillou, P., Moussu, P., Noel, S.F., Sagan, C., Pistorius, M.A., Langlard, J.M., et al. (1997) Spontaneous Dissection of the Celiac Artery. Annals of Vascular Surgery, 11, 413-415. http://dx.doi.org/10.1007/s100169900070
[5]	Matsuo, R., Ohta, Y., Ohya, Y., Kitazono, T., Irie, H., Shikata, T., et al. (2000) Isolated Dissection of the Celiac Artery—A Case Report. Angiology, 51, 603-607. http://dx.doi.org/10.1177/000331970005100710
[6]	D’Ambrosio, N., Friedman, B., Siegel, D., Katz, D., Newatia, A. and Hines, J. (2007) Spontaneous Isolated Dissection of the Celiac Artery: CT Findings in Adults. American Journal of Roentgenology, 188, W506-W511.
[7]	Takayama, T., Miyata, T., Shirakawa, M. and Nagawa, H. (2008) Isolatedspontaneous Dissection of the Splanchnic Arteries. Journal of Vascular Surgery, 48, 329-333. http://dx.doi.org/10.2214/AJR.06.0315
[8]	Obon-Dent, M., Shabaneh, B., Dougherty, K.G. and Strickman, N.E. (2012) Spontaneous Celiac Artery Dissection Case Report and Literature Review. Texas Heart Institute Journal, 39, 703-706. http://dx.doi.org/10.1016/j.jvs.2008.03.002
[9]	Jung, S.C., Lee, W., Park, E.A., Jae, H.J., Chung, J.W. and Park, J.H. (2013) Spontaneous Dissection of the Splanchnic Arteries: CT Findings, Treatment, and Outcome. American Journal of Roentgenology, 200, 219-225. http://dx.doi.org/10.2214/AJR.11.7877
[10]	Mousa, A.Y., Coyle, B.W., Affuso, J., Haser, P.B., Vogell, T.R. and Graham, A.M. (2009) Nonoperative Management of Isolated Celiac and Superior Mesenteric Artery Dissection: Case Report and Review of Literature. Vascular, 17, 359-364. http://dx.doi.org/10.2310/6670.2009.00053
[11]	Glehen, O., Feugier, P., Aleksic, Y., Delannoy, P. and Chevalier, J.M. (2001) Spontaneous Dissection of the Celiac Artery. Annals of Vascular Surgery, 15, 687-692. http://dx.doi.org/10.1007/s10016-001-0012-0
[12]	Batt, M. and Baque, J. (2011) Successful Percutaneous Embolisation of a Symptomatic Celiac Artery Dissection with Aneurysm Dilation with Detachable Vascular Plugs. Journal of Vascular Surgery, 54, 1812-1815. http://dx.doi.org/10.1016/j.jvs.2011.05.016
[13]	Foord, A.G. and Lewis, R.D. (1959) Primary Dissecting Aneurysms of Peripheral and Pulmonary Arteries. Archives of Pathology, 68, 553-577.
[14]	Iha, K., Nakasone, Y., Nakachi, H., Horikawa, Y., Gushiken, M. and Matsuda, H. (2000) Surgical Treatment of Spontaneous Dissection of the Superior Mesenteric Artery: A Case Report. Annals of Thoracic and Cardiovascular Surgery, 6, 65-69.
[15]	Lakin, R.O. and Kashyap, V.S. (2000) Splanchnic Artery Aneurysms. In: Rutherford, R.B., Ed., Vascular Surgery, 8th Editions, WB Saunders Co., Philadelphia, 2220-2235.
[16]	Graham, L.M., Stanley, J.C., Whitehouse Jr, W.M., Zelenock, G.B., Wakefield, T.W., Cronenwett, J.L., et al. (1985) Celiac Artery Aneurysms: Historic (1745-1949) versus Contemporary (1950-1984) Differences in Etiology and Clinical Importance. Journal of Vascular Surgery, 2, 757-764. http://dx.doi.org/10.1016/0741-5214(85)90053-9