scholarly journals Management of celiac trunk and superior mesenteric artery synchronous aneurysms as an extremely rare manifestation of Wegener granulomatosis

2019 ◽  
Vol 5 (4) ◽  
pp. 525-528
Author(s):  
Mohammad Mozaffar ◽  
Mohammad Amin Shahrbaf ◽  
Behzad Azimi ◽  
AmirAhmad Arabzadeh
Author(s):  
Satoru Muro ◽  
Wachirawit Sirirat ◽  
Daisuke Ban ◽  
Yuichi Nagakawa ◽  
Keiichi Akita

AbstractA plate-like structure is located posterior to the portal vein system, between the pancreatic head and roots and/or branches of two major arteries of the aorta: the celiac trunk and superior mesenteric artery. We aimed to clarify the distribution and components of this plate-like structure. Macroscopic examination of the upper abdomen and histological examination of the plate-like structure were performed on 26 cadavers. The plate-like structure is connected to major arteries (aorta, celiac trunk, superior mesenteric artery) and the pancreatic head; it contains abundant fibrous bundles comprising nerves, vessels, collagen fibers, and adipose tissue. Furthermore, it consists of three partly overlapping fibrous components: rich fibrous bundles (superior mesenteric artery plexus) fused to the uncinate process of the pancreas; fibrous bundles arising from the right celiac ganglion and celiac trunk that spread radially to the dorsal side of the pancreatic head and superior mesenteric artery plexus; and fibrous bundles, accompanied by the inferior pancreaticoduodenal artery, entering the pancreatic head. The plate-like structure is the pancreas–major arteries (aorta, celiac trunk, superior mesenteric artery) ligament (P–A ligament). The term “P–A ligament” may be clinically useful and can facilitate comprehensive understanding of the anatomy surrounding the pancreatic head and provide an anatomical basis for further pancreatic surgery studies.


2018 ◽  
Vol 13 (5) ◽  
pp. 945-948
Author(s):  
Kenkichi Michimoto ◽  
Kanichiro Shimizu ◽  
Shunichi Sadaoka ◽  
Jun Miki

2019 ◽  
Vol 27 (2) ◽  
pp. 13-18
Author(s):  
I. V. Gaiyvoronsky ◽  
P. M. Bykov ◽  
M. G. Gaivoronskaya ◽  
G. I. Sinenchenko

The rapid development of transplantation, endovascular and minimally invasive surgery necessitates a detailed study of the structural features of the vessels of the abdominal cavity. The purpose of the study is the characteristics of the morphometric parameters of the abdominal aorta and its unpaired branches in men and women at different ages and depending on the body type. The analysis of 266 computer tomograms of the abdominal part of aorta and its unpaired branches was carried out in adult men women divided into three age groups (first and second periods of mature age and elderly age), as well as into three groups according to the Pinier index (asthenic, normosthenic and hypersthenic body types). It was established that individual morphometric parameters of the abdominal part of aorta and its unpaired branches in men and women significantly change with age. It is proved that the diameter of the aorta at various levels significantly increases with age from the first mature to the elderly age by an average of 5 mm. However, in men, the length of the abdominal aorta, celiac trunk and main trunk of the superior mesenteric artery does not change with age. In women, the length of the celiac trunk increases with age at 5.9 mm, the length of the main trunk of the superior mesenteric artery - at 17 mm. The angle of discharge of the celiac trunk in men changes unevenly with age - in the second period of mature age, there is a statistically significant decrease by an average to 12.3°, then in old age an increase to 15°. Moreover, in women, the values of this indicator vary more evenly. The angles of discharge of other vessels did not show a clear age dependence, since this parameter is largely due to the constitutional features. The aorto-mesenteric distance changes with age only in women. In elderly age, it is on average 4.4 mm larger than in the first period of mature age. It was also found that there are significant differences between constitutional types identified using the Pinier index in the overwhelming majority of the morphometric parameters studied. The obtained information has a significant clinical importance, since it will allow objectifying the diagnostic criteria of various vascular syndromes and minimizing the risk of endovascular interventions.


VASA ◽  
2009 ◽  
Vol 38 (4) ◽  
pp. 394-396 ◽  
Author(s):  
Çakmak ◽  
Gyedu ◽  
Akyol ◽  
İ. Kepenekçi ◽  
Köksoy

Buerger‘s disease is an inflammatory occlusive disease which commonly involves medium-sized or smaller vessels of extremities. Mesenteric involvement in Buerger‘s disease is very rare. It can occur at any time during the course of the disease and presents with acute mesenteric ischaemia. In this study, a case of Buerger‘s disease with mesenteric involvement diagnosed before the onset of acute mesenteric ischaemia and managed endovascularly is reported.


Author(s):  
Giampiero Esposito ◽  
Giangiuseppe Cappabianca ◽  
Gaetano Contegiacomo ◽  
Giuseppe Labriola ◽  
Nunzio Gallo ◽  
...  

Objective Several techniques have been described for the treatment of thoracic and thoracoabdominal aneurysms in patients with mega aortic syndrome (MAS), but the incidence of stroke, spinal cord injury, and endoleaks remains high. We present the midterm results of a new hybrid, multistep technique to treat patients with MAS. Methods From November 2005 to January 2011, 80 patients with MAS underwent hybrid repair of thoracic and thoracoabdominal aneurysms with the Lupiae technique. Forty-six patients presented with chronic aortic aneurysms, and 34 patients who had undergone aortic arch debranching with the Lupiae graft for acute aortic dissection presented with an expanding false lumen into the residual aorta. Sixty patients underwent ascending aorta and arch replacement with a Gelweave Lupiae prosthesis plus epiaortic vessel debranching (thoracic Lupiae procedure). Fourteen patients underwent a thoracic Lupiae procedure plus partial visceral debranching (celiac trunk and superior mesenteric artery) through a mini-laparotomy. Six patients underwent a thoracic Lupiae procedure plus a complete visceral debranching (celiac trunk, superior mesenteric artery, and renal arteries) with the implant of a second Lupiae prosthesis to replace the abdominal aorta. After the surgical steps, all the surviving patients underwent an endovascular procedure to implant multiple stent grafts to exclude the residual segment of diseased aorta. Results In-hospital mortality was 8.4%, and the incidence of temporary renal failure was 5.2%. None of the patients had a stroke or a spinal cord injury, and none of the patients presented endoleaks immediately following the procedure or during the follow-up computed tomography scans. No deaths occurred during the 6-year follow-up after the hybrid procedure. Conclusions These preliminary results showed that the Lupiae technique is a safe and effective option for the treatment of patients with MAS. Indeed, the Lupiae technique achieves complete exclusion of thoracic and thoracoabdominal aneurysms with a low risk of paraplegia and endoleaks.


2019 ◽  
Vol 21 (2) ◽  
pp. 37-42
Author(s):  
I V Gaivoronsky ◽  
P M Bykov ◽  
M G Gaivoronskaya

Computer tomograms of the abdominal part of the aorta and its unpaired branches of adults belonging to three age groups are analyzed: the first, the second mature, and the elderly. It has been established that individual morphometric parameters of the abdominal part of the aorta and its unpaired branches in men and women significantly change with age. It is proved that the diameter of the aorta at different levels significantly increases with age from the first mature age to the elderly by an average of 5 mm. In addition, in men, the length of the abdominal aorta, celiac trunk and main trunk of the superior mesenteric artery do not change with age. In women, the length of the celiac trunk increases with age by 5,9 mm, the length of the main trunk of the superior mesenteric artery - by 17 mm. It can be assumed that this fact is due to the structural features of the connective tissue structures of the arterial wall in women, and, in particular, the elastic framework. The angle of discharge of the celiac trunk in men changes unevenly with age - in the second period of mature age, there is a statistically significant decrease on average of 12,3°, then in old age an increase of 15°. Moreover, in women, the values of this indicator vary more evenly. The angles of discharge of other vessels did not show a clear age dependence, since this parameter is largely due to the constitutional features. The aorto-mesenteric distance changes with age only in women. In old age, it is on average 4,4 mm larger than in the first period of mature age. In general, a number of morphometric parameters of the abdominal part of the aorta and its unpaired branches significantly changes with age. The findings are important for endovascular interventions.


Author(s):  
Pawan Sarda ◽  
Goutam Kumar ◽  
Deepak Gupta ◽  
Sanjeev Sanghvi ◽  
Anil Baroopal

Background: Chronic mesenteric ischemia (CMI) or mesenteric angina is a condition characterised by inadequate blood supply to bowel as a result of stenosis affecting   one or more of the three mesenteric arteries: the celiac artery (CA), the superior mesenteric artery (SMA) and the inferior mesenteric artery (IMA).Methods: Ten patients with significant lesion, treated with PTA and stenting were selected for study and were followed at 2 weeks, at 2 months then at 6 months after index procedure to see composite of symptomatic improvement, weight gain and revascularization.Results: On mesenteric angiography, significant ostial stenosis of celiac trunk and superior mesenteric artery in 5 patients, 3 patients had significant ostial stenosis of celiac trunk and ostial stenosis of inferior mesenteric artery and 2 patients had significant stenosis of superior mesenteric artery. Percutaneous transluminal angioplasty (PTA) and stenting was done, final result was good and there was no residual stenosis and dissection. After stenting patients were stable and pain free. There were no post-operative complications. Follow up was done after 2 weeks and 2 months and then at six months. There was no postprandial abdominal pain on follow up and almost all patient had gained weight in 2 months and on 6 months of follow up, no case of repeat revascularization was recorded.Conclusions: Percutaneous transluminal angioplasty (PTA) and stenting to mesenteric artery is good alternative management of CMI. In present series, all cases were susses fully revascularized without residual stenosis and dissection.


2009 ◽  
Vol 8 (3) ◽  
pp. 271-273 ◽  
Author(s):  
K. Sridhar Varma ◽  
Narendra Pamidi ◽  
Venkata R. Vollala

Common celiacomesenteric trunk, with the celiac and superior mesenteric arteries having a common origin from the aorta, is the least frequently reported anatomic variation of all abdominal vascular anomalies. Knowledge of variations concerning the celiac trunk and superior mesenteric artery are of great importance for both surgical approaches and angiographic examinations. Clinicians should keep in mind these variations to avoid complications.


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