Pancreaticoduodenal arcade

Supraduodenal artery - This vessel provides blood supply to the upper portion of the duodenum and pylorus [2]. The origin of this vessel is also variable, and it communicates with the pancreaticoduodenal arcade as well as right gastric branches [7]. If identified, this vessel should be prophylactically embolized. 

Antegrade obliteration of the superior duodenal branches via the gastroduodenal artery is often insufficient alone, as the bleeding points can be quickly pressurized via the rich anastomotic connections from the inferior pancreaticoduodenal arcade. In such cases, a coil-sandwich technique or alternatively direct obliteration of the bleeding segment or pseudoaneurysm by nested coils or a casting agent may be needed to prevent recurrence. 

The duodenum is supplied by the pancreaticoduodenal arteries, consisting of two, sometimes three or more trunks bridging the gastroduodenal and superior mesenteric artery. One pancreaticoduodenal arcade is located anteriorly (mostly as a continuation of the gastroduodenal artery) and one posteriorly, with multiple anastomoses between them and other pancreatic arteries, building a rich collateral plexus (Fig. 5.4). 

Fig. 5.4. DSA of the gastroduodenal artery with a 5-F Cobra catheter (white arrows). Anterior (black arrowheads) and posterior (white arrowheads) pancreaticoduodenal arcades originating with superior and inferior common trunks. Multiple interconnected mural arteries (small black arrowheads) build loops (small white arrowheads) between the upper and the lower arcade, completing the dual duodenal supply. Superior mesenteric artery (black arrows)...

Gastroduodenal, pancreaticoduodenal arcade. Also called muscular branches. 

The gastroduodenal artery arises from the common hepatic artery and supplies branches to the pancreatic head via the superior pancreaticoduodenal arcade (SPDA) and greater curvature of the stomach via the gastroepiploic It is an excellent collateral vessel connecting the celiac to the SMA if either one becomes occluded. 

The SMA arises at the LI level and supplies the small bowel via jejunal and ileal branches, the right and middle colon via the ileocolic, right and middle colic arteries, as well as the pancreatic head via the inferior pancreaticoduodenal arcade (I PDA). 

Yamaguchi H, Wakiguchi S, Murakami G (2001) Blood supply to the duodenal papilla and the communicating artery between the anterior and posterior pancreaticoduodenal arterial arcades. J Hepato Biliary Pancreatic Surg... 

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