In addition, change in caliber of the abdominal aorta was noted below the celiac axis
Under local anesthesia (Lidocaine 2%) and using the Seldinger technique, a selective celiac axis
catheterization (Cobra Glidecath, 5F, 65-cm-long) with a guidewire (Radifocus guidewire, 0.035", 150-cm-long) confirmed the large right gastroepiploic artery pseudoaneurysm (Figure 2).
Computed tomography angiography (CTA) of aorta showed a saccular SCAA with maximal diameter of 6.0 cm, which arose from the posterior aspect of celiac axis
level of aorta and enlarged posteriorly [Figure 1]a.
Radiologists also tend not to report celiac axis
stenosis with only collateral circulations unless accompanied by aneurysms in asymptomatic patients because they are not familiar with the clinical significance of this disease entity.
A study conducted by Hansen et al revealed that asymptomatic celiac axis
or superior mesenteric artery stenosis can be identified at duplex ultrasonography in over 17% of the elderly.
Excessive angulation of the celiac axis
and tortuosity of the splenic artery may result in failure of endovascular procedures.
Lack of these risk factors favors true aneurysms, especially when celiac axis
Ito et al., "Endovascular management of ruptured pancreaticoduodenal artery aneurysms associated with celiac axis
stenosis," CardioVascular and Interventional Radiology, vol.
Median arcuate ligament (MAL) is a fibrous arch at T12 and L1 level that bridges the diaphragmatic crura on either side of the aortic hiatus.1-4 It is used as an anatomical landmark in the localization of renal hilum in the laparoscopic surgeries.5 The ligament usually passes above the origin of celiac axis
, however in 10% to 24% people it inserts lower down crossing the root of the celiac axis
The CTA incidentally depicts a common origin for the celiac axis
and SMA from the abdominal aorta (celiacomesenteric trunk) (Figures 1, 2).