Evolving Diagnostic and Therapeutic Options for Visceral Artery Aneurysms

Johal, Monika; Kalaravy, Mayurey; Ali, Fahad; Barve, Rajas; Ahmed, Amna; Francis, Chris; Harky, Amer

doi:10.1016/j.avsg.2021.03.012

Cited by 6 publications

(20 citation statements)

References 66 publications

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“…The prevalence of visceral artery aneurysms (VAAs), i.e., a dilatation to the extent of at least 1.5 times the size of the original vessel involving the main trunk of splanchnic arteries and/or their branches [ 1 ], is estimated to be low, ranging between 0.01 and 2% on autopsy series [ 2 , 3 ], though their incidental finding, particularly in asymptomatic patients, have been increasingly reported, in relation to a widespread application of the modern and sophisticated radiologic imaging [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Distribution of VAAs varies greatly among the different series, with splenic artery (SA) aneurysms being the most common (30–60%), followed by celiac trunk (CTA) (2–46%), hepatic (HA) (4–30%), superior mesenteric (SMA) (2–9%), and inferior mesenteric artery (IMA) (1%) aneurysms [ 1 , 2 , 4 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Among branch aneurysms, those arising at the level of pancreaticoduodenal (PDA) and gastroduodenal (GDA) arteries are the most frequently detected, with a prevalence varying between 2 and 15%, whereas those involving the gastric-gastroepiploic (GA-GEA), jejunal (JA), ileal (IA), and colic arteries (CA) have the lowest incidence, documented at 2–5% [ 1 , 2 , 4 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Aneurysm multiplicity, defined as a concomitant presence of other aneurysms in a separate vascular bed [ 2 ], might occur in approximately 20–50% of all VAAs [ 1 , 2 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…While the current routinary adoption of procedures involving the liver, biliary tree, and pancreas have led to a significantly increasing documented incidence of iatrogenic pseudoaneurysms, especially at the level of HAs, PDAs, and GDAs [ 8 , 9 ], differently from infectious (mycotic) aneurysms, whose frequency is constantly reported decreasing [ 1 ], no mention exists in literature of a causal association between splanchnic aneurysms and inflammatory bowel diseases (IBD).…”

Section: Introductionmentioning

confidence: 99%

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Crohn’s Disease and Jejunal Artery Aneurysms: A Report of the First Case and a Review of the Literature

et al. 2022

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Background and Objectives: Jejunal artery (JA) and ileal artery (IA) aneurysms constitute less than 3% of all visceral artery aneurysms (VAAs), carrying a risk of rupture as high as 30%, and a mortality of 20%. Though many etiologies have been reported in the literature, no mention exists on a causal association between these aneurysms and inflammatory bowel diseases (IBD). We present the first case of a JA aneurysm related to Crohn’s Disease (CD) together with a review of the literature. Materials and Methods: A 74-year-old male presenting with CD intestinal relapse and an incidental finding at the computed tomography enterography (CTE) of a 53 × 47 × 25mm apparently intact JA pseudoaneurysm, arising from the first and second jejunal branches, underwent coil embolization followed by small bowel resection, with an uneventful outcome. We also included the review of literature on JA and IA aneurysms, analyzing all reports published in PubMed and Scopus from 1943 to July 2022. Results: 60 manuscripts with 103 cases of JA and IA aneurysms in 100 patients were identified. Among cases with available data, 34 (33.0%) presented acutely with rupture, 45 (43.7%) were described as non-ruptured. 83 (80.6%), and 14 (13.6%) were JA and IA aneurysms, respectively, having a median size of 15 (range:3.5–52) mm. Atherosclerosis (16.5%), infections (10.7%), and vasculitides/connective tissue disorders (9.7%) represented the main causes mentioned. Mean age was 53.6 (±19.2) years, male patients being 59.4%. One third of patients (32.4%) were asymptomatic. Overall, treatment was indicated in 63% of patients, with surgery and endovascular procedures performed in 61.9% and 38.1% cases, respectively. The technical success rate of endovascular treatment (EVT) was 95.8%. The mortality rate was 11.8%, being higher (21.2%) in the rupture group. Conclusions: The prompt treatment accomplished in our case granted a successful outcome. JA and IA aneurysms should be included among local complications of IBD. Considering their high potential for rupture, regardless of size, a low threshold for endovascular or surgical treatment should be applied.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Aneurysm multiplicity, defined as a concomitant presence of other aneurysms in a separate vascular bed [ 2 ], might occur in approximately 20–50% of all VAAs [ 1 , 2 , 7 ].…”

Section: Introductionmentioning

confidence: 99%