title: Inferior pancreaticoduodenal artery aneurysm treated with coil packing and stent placement.
abstract: Two cases with a pancreaticoduodenal arterial aneurysm accompanied with superior mesenteric artery (SMA) stenosis were previously described and both were treated surgically. However, for interventional treatment, securing a sufficient blood supply to the SMA should be a priority of treatment. We present the case of a 71-year-old male with a 20 mm diameter pancreaticoduodenal arterial aneurysm accompanied by SMA stenosis at its origin. The guidewire traverse from SMA to the aneurysm was difficult because of the tight SMA stenosis; however, the guidewire traverse from the celiac artery was finally successful and was followed by balloon angioplasty using a pull-through technique, leading to stent placement. Thereafter, coil packing through the SMA achieved eradication of the aneurysm without bowel ischemia. At the last follow-up computed tomography 8 mo later, no recurrence of the aneurysm was confirmed. The pull-through technique was useful for angioplasty for tight SMA stenosis in this case.
authors.affiliation: Akira Ikoma, Motoki Nakai, Morio Sato, Nobuyuki Kawai, Takami Tanaka, Hiroki Sanda, Kouhei Nakata, Hiroki Minamiguchi, Tetsuo Sonomura, Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama 641-8510, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Ikoma
authors.forename: Motoki
authors.initials: M
authors.lastname: Nakai
authors.forename: Morio
authors.initials: M
authors.lastname: Sato
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kawai
authors.forename: Takami
authors.initials: T
authors.lastname: Tanaka
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sanda
authors.forename: Kouhei
authors.initials: K
authors.lastname: Nakata
authors.forename: Hiroki
authors.initials: H
authors.lastname: Minamiguchi
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Sonomura