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Case Reports
. 2024 Apr 15;10(4):101505.
doi: 10.1016/j.jvscit.2024.101505. eCollection 2024 Aug.

Hybrid approach to intrapancreatic inferior pancreaticoduodenal aneurysm repair

Caitlin McGinty  1 , Ryan Bird  1 , Amarseen Mikael  1 , S Frontario  1 , Robert Pergolizzi  1 , Thomas Bernik  1
Affiliations
Case Reports

Hybrid approach to intrapancreatic inferior pancreaticoduodenal aneurysm repair

Caitlin McGinty et al. J Vasc Surg Cases Innov Tech. .

Abstract

Pancreaticoduodenal artery aneurysms (PDAAs) are an extremely rare visceral artery aneurysm subtype, usually managed by endovascular techniques. We report the case of a 57-year-old man with an intrapancreatic, inferior PDAA abutting the superior mesenteric artery (SMA). This location, in relation to the SMA, risks SMA thrombosis using an endovascular-only approach. Our approach consisted of open exploration and ligation of the inferior PDAA junction at the SMA, followed by endovascular coil embolization of the aneurysm. This case serves as a reminder that although many vascular diseases can be treated with less invasive endovascular strategies, open surgery can sometimes be the safer alternative.

Keywords: Hybrid approach; Inferior pancreaticoduodenal aneurysm; Open surgery; Pancreaticoduodenal artery aneurysms; Superior mesenteric artery; Visceral artery aneurysms.

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Conflict of interest statement

None.

Figures

Fig 1
Fig 1
Computed tomography scan showing a 2.2-cm inferior pancreaticoduodenal aneurysm (arrow) adjacent to the superior mesenteric artery (SMA).
Fig 2
Fig 2
Magnetic resonance image of the aneurysm (arrow) within the pancreaticoduodenal artery (PDA).
Fig 3
Fig 3
Angiogram via the left radial artery approach showing an indistinct branch point between the inferior pancreaticoduodenal artery aneurysm (PDAA) (arrow) and superior mesenteric artery (SMA).
Fig 4
Fig 4
Open exposure of superior mesenteric artery (SMA) and aneurysm.
See this image and copyright information in PMC

References

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