Review Endovascular treatment of celiac axis aneurysm with a covered stent: Case presentation and review of the literature Micheal T Ayad, Phillip Batista, Anu K. Whisenhunt, Dawn Salvatore, Babak Abai, Paul J DiMuzio n Division of Vascular and Endovascular Surgery, Thomas Jefferson University Hospital,111 S.11th St, Suite 6270, Philadelphia, PA 19107, USA article info Article history: Received 15 February 2014 Accepted 19 March 2014 Keywords: Celiac artery Aneurysm Endovascular treatment abstract Objective: To report the safe and effective treatment of celiac axis aneurysm (CAA) using a covered stent plus coil embolization of the gastric and splenic arteries, and to assess the results of similar cases treated using endovascular techniques. Methods: Case report and PUBMED literature review (2000–2013) of cases treated using endovascular techniques. Results: Successful exclusion of an enlarging CAA was performed using a covered stent placed from the origin of the axis into the common hepatic artery via a brachial approach; concomitantly, the splenic and gastric arteries were embolized. A PUBMED literature review revealed the successful endovascular treatment of CAA in 25. Stent graft exclusion was described a total of seven times: three within the axis itself, three landing in the splenic artery, and one landing in the hepatic artery. Conclusions: Various methods of endovascular treatment of CAA have been reported to be safe and effective. Depending upon anatomy, this report suggests that preservation of blood flow to the hepatic artery with coil embolization of the gastric and splenic arteries is effective in treating this condition while maintaining important foregut blood flow. & 2014 Elsevier B.V. All rights reserved. Contents Introduction.............................................................................................................. 1 Case report .............................................................................................................. 2 Discussion ............................................................................................................... 4 Conflict of Interest......................................................................................................... 5 References ............................................................................................................... 5 Introduction Celiac axis aneurysm (CAA) is a rare entity, comprising only 5% of all visceral arterial aneurysms [1–5]. Management has tradi- tionally involved open repair to prevent rupture. Even though the incidence of rupture has not been accurately defined due to the rarity of CAA, it is estimated to occur in approximately 15–20% of cases [2,5,6]. Elective repair is generally indicated when an aneurysm reaches 2 cm in diameter, or becomes symptomatic. Various open surgical techniques have been described, including aneurysmectomy with bypass, aneurysmorraphy, and ligation without revascularization [4–8]. Over the past decade, endovascular surgical techniques have emerged as an attractive alternative to the open surgical treatment of CAA. These have included embolization and various configura- tions of stent grafts [4–8]. Surprisingly, only one case of stent grafting landing into the hepatic artery, thereby preserving blood flow into this important branch of the CA, has been previously described [6]. Herein, we present the exclusion of an asymptomatic CAA using stent graft placed from the origin of the celiac axis into the common hepatic artery combined with coil embolization of the splenic and left gastric arteries. In addition, we present a review of the literature outlining the previously reported cases of CAA Contents lists available at ScienceDirect journal homepage: www.elsevier.com/locate/rvm Reviews in Vascular Medicine http://dx.doi.org/10.1016/j.rvm.2014.03.002 2212-0211/& 2014 Elsevier B.V. All rights reserved. n Corresponding author. Tel.: þ1 215 955 4375; fax: þ1 215 925 0835. E-mail address: paul.dimuzio@jefferson.edu (P. DiMuzio). Please cite this article as: Ayad MT, et al. Endovascular treatment of celiac axis aneurysm with a covered stent: Case presentation and review of the literature. Reviews in Vascular Medicine (2014), http://dx.doi.org/10.1016/j.rvm.2014.03.002i Reviews in Vascular Medicine ∎ (∎∎∎∎) ∎∎∎–∎∎∎