Inferior Pancreaticoduodenal Artery Aneurysms in Association with Celiac Axis Stenosis or Occlusion

Graphic representation of the normal anatomy of the pancreaticoduodenal arcades (AA) and dorsal pancreatic artery (DPA). SMA=Superior Mesenteric Artery; LGA: Left Gastric Artery; PHA: Proper Hepatic Artery; GDA: Gastroduodenal artery' RGEp: Right Gastro-Epiploic Artery; SPDA: Superior Pancreaticoduodenal Artery; IPDA: Inferior Pancreaticoduodenal Artery; DPA: Dorsal Pancreatic Artery; HB: Horizontal or transverse branch of dorsal pancreatic artery; VB: Vertical branch of dorsal pancreatic artery; TPA: Transverse pancreatic artery; Spl. A: Spleenic Artery.

Enlarged anterior and posterior pancreaticoduodenal arcades in a patient with celiac axis occlusion: Selective arteriogram with catheter in the inferior pancreaticoduodenal artery (black arrow) shows enlarged anterior (white arrow) and posterior (arrowhead) pancreaticoduodenal arcades that reconstitute the entire celiac axis.

Elective endovascular coil occlusion of a large IPDA aneurysm in a 62 year old male patient. (A) Sagital subvolume (7.5mm thick) maximum intensity projection of a CT angiography data set shows occluded (arrow) celiac axis. (B) Axial CT image at the level of the uncinate process of the pancreas shows a moderate sized aneurysm (arrow). (C) The aneurysm was successfully embolized with coils (arrow). (D) The occluded celiac axis was treated with angioplasty and stent (arrow) placement.

Endovascular coil occlusion of multiple IPDA aneurysms in a 58 year old male patient who presented with gastrointestinal bleed. (A) Superior mesenteric arteriogram shows two small aneurysms (arrows) of the pancreaticoduodenal arcades. In addition, the arcades and the dorsal pancreatic arteries are enlarged and the hepatic arteries are opacified. (B) The aneurysms were successfully embolized with coils (arrows).

Aneurysm of dorsal pancreatic artery. Selective arteriogram of the inferior pancreaticoduodenal artery (arrowhead) shows an aneurysm (arrow) in the proximal segment of the dorsal pancreatic artery.