In addition, change in caliber of the abdominal aorta was noted below the
celiac axis level (Fig.
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 stenosis/occlusion coexists.
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).
celiac artery - an artery that originates from the abdominal aorta just below the diaphragm and branches into the left gastric artery and the common hepatic artery and the splenic artery