Unruptured Giant Aneurysm of The Inferior Pancreaticoduodenal Artery with Superior Mesenteric Artery Stenosis Obstructed by Spontaneous Thrombosis After Superior Mesenteric Artery Angioplasty: A Case Report

Most pancreaticoduodenal artery aneurysms involve celiac trunk stenosis or occlusion. Few cases have been related to superior mesenteric artery (SMA) stenosis, and none of these was treated with SMA angioplasty before transcatheter arterial embolization (TAE) or operative resection of the aneurysm. We treated a 79-year-old woman with incidentally detected inferior pancreaticoduodenal artery aneurysms, presumably secondary to SMA stenosis. Abdominal angiography indicated that TAE of the aneurysms would disturb collateral flow and cause SMA ischemia, so SMA angioplasty was performed before TAE of the aneurysms. Arteriography of the SMA six days after angioplasty revealed partial thrombosis in the giant aneurysm. The smaller aneurysm was then embolized to occlude collateral flow, which facilitated further thrombosis of the giant aneurysm without recurrence.