Celiac artery compression syndrome due to acute type B aortic dissection.
Acute distal aortic dissection sometimes causes one or more visceral vessels to be stenosed by the thrombosed false lumen. Although stenosis of the only celiac artery (CA) usually does not cause ischemic symptoms because of the extensive collateral pathways of the mesenteric circulation, we experienced a rare case of CA compression syndrome which was caused by acute type B aortic dissection. The principal symptom was severe epigastric pain that was refractory to medicinal treatment. The angiogram showed absence of the anatomically well-developed collateral pathways between the CA and the superior mesenteric artery. We treated the patient with percutaneous transluminal angioplasty in the CA. This report indicates that attention should be given to the possibility of CA compression syndrome in the case of acute distal aortic dissection and that endovascular management can be successfully applied to control symptoms caused by the syndrome, which is otherwise extremely difficult to repair directly by surgery.
Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan. fuji@sapmed.ac.jp
Yasuaki
Y
Fujisawa
Kiyofumi
K
Morishita
Johji
J
Fukada
Yoshikazu
Y
Hachiro
Nobuyoshi
N
Kawaharada
Tomio
T
Abe
D000784:Aortic Dissection / Q000150:complications* / Q000000981:diagnostic imaging; D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon; D001014:Aortic Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging; D002445:Celiac Artery / Q000473:pathology*; D003097:Collateral Circulation; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging; D008875:Middle Aged; D015607:Stents