Visceral artery aneurysms: series of 17 cases treated in a single center

Int Angiol. 2010 Feb;29(1):30-6.

Abstract

Aim: The aim of this study is to evaluate early and long term results obtained with a retrospective review in 8-year experience with surgical/endovascular treatment of visceral artery aneurysm (VAA) in a single center.

Methods: Between 2001 and 2008 in our vascular surgery unit visceral artery aneurysms were diagnosed with CT and/or angiography in 17 patients (9 male), mean age 66 years old (range: 18 to 78). All patients underwent surgical or endovascular treatment of splanchnic artery aneurysm. In 14 patients the localization was single, in 3 it was multiple. The arteries involved were: splenic artery 53%, superior mesenteric artery 17.7%, pancreaticoduodenal artery 17.7%, celiac axis 5.8% and hepatic artery 5.8%. The 29.4% of the patients presented with aneurysm rupture. Coil embolizzation was used in 11.6% of the cases while surgery was used in 88.4% of the cases.

Results: Total survival rate was 94.2%, the survival rate in emergency cases was 80% while it was 100% in elective cases. Follow-up revealed excellent results after an average of 46 months (range: 8-102).

Conclusion: The worst prognosis for ruptured cases associated with the good result of the surgical/endovascular treatment in elective cases, suggests active interaction for such pathologies; in emergency cases the mortality incidence is too high. Today endovascular treatment presents lower morbidity and mortality rates and shorter hospitalization, but surgery is still a good therapeutic option for the treatment of the VAA, in subjects with low surgical risk, determining a definitive and long-lasting correction of the aneurysmal pathology and guaranteeing the correct perfusion of the organs, by grafts; moreover many aneurysms are not suitable for endovascular treatment.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aneurysm / diagnostic imaging
  • Aneurysm / mortality
  • Aneurysm / surgery
  • Aneurysm / therapy*
  • Aneurysm, Ruptured / diagnostic imaging
  • Aneurysm, Ruptured / mortality
  • Aneurysm, Ruptured / surgery
  • Aneurysm, Ruptured / therapy*
  • Arteries / surgery
  • Elective Surgical Procedures
  • Embolization, Therapeutic* / adverse effects
  • Embolization, Therapeutic* / mortality
  • Female
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Assessment
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Vascular Surgical Procedures* / adverse effects
  • Vascular Surgical Procedures* / mortality
  • Viscera / blood supply*
  • Young Adult