title: Ruptured pancreaticoduodenal artery aneurysm associated with median arcuate ligament compression and aortic dissection successfully treated with embolotherapy.
abstract: A 51-year-old man with a ruptured pancreaticoduodenal artery (PDA) aneurysm caused by compression of the celiac artery by the median arcuate ligament and aortic dissection involving the celiac axis was transferred to our hospital for endovascular treatment. A 4-F catheter was advanced into the superior mesenteric artery through the narrow true lumen via the left brachial artery, and coil embolization of the aneurysm was successfully performed. In this case, rapid increase of blood flow in the superior mesenteric artery, which compensated for the decreased celiac blood flow by aortic dissection, increased hemodynamic stress on the PDA, leading to aneurysmal rupture.
authors.affiliation: Department of Diagnostic Radiology, Fukuiken Saiseikai Hospital, Fukui, Fukui, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Miyayama
authors.affiliation: Department of Surgery, Fukuiken Saiseikai Hospital, Fukui, Fukui, Japan.
authors.forename: Takuro
authors.initials: T
authors.lastname: Terada
authors.affiliation: Department of Surgery, Fukui Cardiovascular Center, Fukui, Fukui, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Tamaki
keywords: aortic dissection; median arcuate ligament; pancreaticoduodenal artery aneurysm
references.citation: J Vasc Surg. 2012 Oct;56(4):1114-8
references.pmid: 22795523
references.citation: Ann Vasc Surg. 1990 Nov;4(6):540-5
references.pmid: 2261321
references.citation: Radiographics. 2005 Sep-Oct;25(5):1177-82
references.pmid: 16160104
references.citation: J Gastroenterol. 1998 Jun;33(3):434-8
references.pmid: 9658327
references.citation: Semin Intervent Radiol. 2009 Sep;26(3):215-23
references.pmid: 21326566
references.citation: Ann Vasc Dis. 2014;7(1):87-92
references.pmid: 24719672
references.citation: Ann Vasc Dis. 2013;6(2):198-201
references.pmid: 23825502
references.citation: Ann Vasc Surg. 1996 Sep;10(5):506-15
references.pmid: 8905073
references.citation: Ann Surg. 1999 Mar;229(3):416-20
references.pmid: 10077055