ENDOVASCULAR MANAGEMENT AND OUTCOMES OF VISCERAL ARTERIAL ANEURYSMS — SINGLE CENTRE EXPERIENCE
DOI:
https://doi.org/10.48750/acv.251Keywords:
visceral artery aneurysm, visceral artery pseudoaneurysm, endovascular procedures, embolization, covered stent, outcome analysisAbstract
Introduction: Over the past decade, endovascular treatment (EVT) is taking over visceral arterial aneurysms treatment considering its effectiveness, safety and minimal invasiveness. Methods: We retrospectively evaluated our department experience in visceral arterial aneurysms endovascular approach from 2009 to 2019.
Results: From 2009 to 2019, nineteen visceral artery aneurysms were submitted to EVT (mean age 62,5 years, 53% women). The addressed arterial segments were: the splenic artery (52%, n=10) followed by the renal artery (21%, n = 4), the hepatic artery (11%, n = 2), the superior mesenteric artery (11%, n = 2) and the celiac arrtery (5%, n = 1). Average diameter was 26,9 ± 5,4 mm [range 21–39 mm]. The majority were asymptomatic incidental findings (74%). Concomitant aneurysms were found in 3 patients (15,8%). EVT included: stent-graft exclusion (n = 9), aneurysm-sac coil embolization (n = 6), stent-assisted coil embolization (n=2) and segmental artery exclusion (n=2). Median radiological follow-up was 46,8 months [range 1,1–128 months]. Early SMA occlusion was reported in one case after stent-assisted coil embolization, however without ischemic symptoms. End-organ loss was reported in one case (renal artery coil embolization, without overall renal function worsening).
Conclusion: Nowadays, endovascular approach is the first-line intervention for most visceral arterial aneurysms. Although still limited, the reported results are favourable and are in line with the current literature.
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References
2. Pitton, M. B. et al. Visceral artery aneurysms : Incidence , management , and outcome analysis in a tertiary care center over one decade. (2015). doi:10.1007/s00330-015-3599-1
3. Rabih A. Chaer, MD, Christopher J. Abularrage, MD, Dawn M. Coleman, MD, Mohammad H. Eslami, MD, Vikram S. Kashyap, MD, Caron Rockman, MD, M. Hassan Murad, M. The Society for Vascular Surgery Clinical Practice Guidelines on the Management of Visceral Aneurysms (DRAFT). (2019).
4. Loffroy, R. et al. World Journal of Radiology © 2015. 7, (2015).
5. Wojtaszek, B. M. Managing Visceral Artery Aneurysms. (2013).
6. Regus, S. & Lang, W. Rupture Risk and Etiology of Visceral Artery Aneurysms and Pseudoaneurysms : A Single-Center Experience. 50, 10–15 (2016).
7. Committee, W. et al. Editor ’ s Choice e Management of the Diseases of Mesenteric Arteries and Veins Clinical Practice Guidelines of the European Society of Vascular Surgery ( ESVS ). 460–510 (2017). doi:10.1016/j.ejvs.2017.01.010
8. Song, C., Dong, J., Yu, G., Zhou, J. & Xiang, F. Comparison of open surgery and endovascular procedures as a therapeutic choice for visceral artery aneurysms. (2017). doi:10.1177/1708538117744102
9. Venturini, M. et al. Endovascular Repair of 40 Visceral Artery Aneurysms and Pseudoaneurysms with the Viabahn Stent-Graft : Technical Aspects , Clinical Outcome and Mid-Term Patency. 385–397 (2018). doi:10.1007/s00270-017-1844-5
