Hybrid approach to intrapancreatic inferior pancreaticoduodenal aneurysm repair

Abstract

Pancreaticoduodenal artery aneurysms (PDAAs) are an extremely rare visceral artery aneurysm subtype, usually managed by endovascular techniques. We report the case of a 57-year-old man with an intrapancreatic, inferior PDAA abutting the superior mesenteric artery (SMA). This location, in relation to the SMA, risks SMA thrombosis using an endovascular-only approach. Our approach consisted of open exploration and ligation of the inferior PDAA junction at the SMA, followed by endovascular coil embolization of the aneurysm. This case serves as a reminder that although many vascular diseases can be treated with less invasive endovascular strategies, open surgery can sometimes be the safer alternative.

Keywords

• Hybrid approach
• Inferior pancreaticoduodenal aneurysm
• Open surgery
• Pancreaticoduodenal artery aneurysms
• Superior mesenteric artery
• Visceral artery aneurysms