Trattamento transradiale di aneurisma complesso del tripode celiaco: descrizione di un caso e revisione della letteratura

Celiac trunk aneurysms are uncommon vascular lesions; treatment is usually an open surgical operation; in the medical literature, only few cases of celiac aneurysm treated with endovascular technique are reported; coil positioning or stent-graft placement are described using a femoral vascular access as first choice.Here we describe the case of a 57-year-old man with an asymptomatic large celiac trunk aneurysm involving the origin of the splenic, left gastric and hepatic arteries. The patient was treated in an elective clinical setting with a totally endovascular procedure performed through the left radial artery. First, two vascular plugs were put into splenic and gastric artery, respectively, to prevent type II endoleak, then the aneurysm was closed using a balloon expandable stent-graft into the celiac trunk-hepatic axis. The procedure was completed without any complication. The computed tomography angiography scan confirmed total occlusion of the aneurysm and normal blood flow in the visceral arteries.This case shows that endovascular technique is effective and safe also for the treatment of very complex vascular lesions, and radial access could be considered the preferred choice to minimize access-related vascular complications.