Balloon occlusion of the celiac artery: a test for evaluation of collateral circulation prior endovascular coverage.

Abstract

Visceral ischemia is a possible complication after endovascular coverage of the celiac artery (CA). A selective mesenteric angiography during simultaneous balloon occlusion of the CA imitates endovascular coverage and might therefore be suited for evaluation of collateral circulation. We report the feasibility of a balloon occlusion test (BOT) of the CA for this purpose. We performed a BOT in 5 patients selected for endovascular surgery with intended coverage of the CA. The BOT could demonstrate sufficient collateral circulation in all cases, which was not evident without occlusion of the CA. The most important collateral vessels were the pancreaticoduodenal arcades and the dorsal pancreatic artery. All patients tolerated the BOT well without abdominal symptoms or pathological laboratory findings. Our report suggests that a BOT of the CA is a feasible and safe procedure. It can demonstrate collateral pathways before definite coverage is performed. This test might be useful for selection of patients prior intended coverage of the CA.