Single-Center Experience in the Treatment of Visceral Artery Aneurysms

Martinelli, Ombretta; Giglio, Alessandra; Irace, L; Girolamo, Alessia Di; Gossetti, Bruno; Gattuso, Roberto

doi:10.1016/j.avsg.2019.01.010

Cited by 36 publications

(22 citation statements)

References 21 publications

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“…4) [20,35,36]. In selective cases, a covered self-expanding stent can be placed to preserve the perfusion of blood to the distal target organ [37][38][39]. According to a report on EVT of 44 selfexpandable stent graft procedures in 40 patients performed for 16 true VAAs and 24 pseudoaneurysms, there were 19 elective procedures and 25 emergency procedures performed to manage ruptured aneurysms [39].…”

Section: Endovascular Therapy (Evt)mentioning

confidence: 99%

Current management strategies for visceral artery aneurysms: an overview

et al. 2019

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Visceral artery aneurysms (VAAs) are rare and affect the celiac artery, superior mesenteric artery, and inferior mesenteric artery, and their branches. The natural history of VAAs is not well understood as they are often asymptomatic and found incidentally; however, they carry a risk of rupture that can result in death from hemorrhage in the peritoneal cavity, retroperitoneal space, or gastrointestinal tract. Recent advances in imaging technology and its availability allow us to diagnose all types of VAA. VAAs can be treated by open surgery, laparoscopic surgery, endovascular therapy, or a hybrid approach. However, there are still no specific indications for the treatment of VAAs, and the best strategy depends on the anatomical location of the aneurysm as well as the clinical presentation of the patient. This article reviews the literature on the etiology, clinical features, diagnosis, and anatomic characteristics of each type of VAA and discusses the current options for their treatment and management.

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Section: Endovascular Therapy (Evt)mentioning

confidence: 99%

Current management strategies for visceral artery aneurysms: an overview

et al. 2019

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“…For all others, there remains no consensus in the literature regarding the appropriate treatment for ruptured SAA, especially in the pregnant patient. Endovascular embolization has a lower perioperative morbidity compared with open surgery, but is usually reserved for smaller and non-ruptured aneurysms [25][26][27] For this patient, a multidisciplinary approach provided a favorable outcome in this worst-case-scenario of a large, proximal, ruptured splenic artery aneurysm in the setting of pregnancy.…”

Section: Resultsmentioning

confidence: 99%

A Unique Presentation of Splenic Artery Aneurysm During Pregnancy

Kania¹,

Hawkins²,

Sim³

et al. 2020

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Visceral arterial (VAA) and, specifically, splenic arterial aneurysms (SAA) are rare entities often associated with pregnancy. When ruptured, they can be fatal and require emergent management. This case report includes a review of the relevant literature and describes a unique, multidisciplinary approach to managing such an aneurysm. We describe the difficult situation of an already rupturing aneurysm and the careful coordination of obstetric, surgical, vascular, and interventional radiology teams. The distinctiveness of this case continues with the intraoperative finding of metallic coils freely protruding into the peritoneum from a recently coil-embolized ruptured splenic artery aneurysm. Such iatrogenic foreign bodies are a product of the integration of multiple specialities that can provide life-saving care when managing critical surgical disease such as ruptured splenic artery aneurysms. Multidisciplinary approaches should be considered depending upon the resources available at one's institution.

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“…Debate remains for years on the consensus for the first-line therapy for lesions that are both suitable for open and endovascular surgery. We summarized publications of SMAA with at least three cases in recent 10 years 11 , 30–32 (Table 5), and found that first-line therapy and reporting standard varies between different centers, which, to some degree, indicate the lack of a powerful guideline and also the complex and individual nature of SMAA. However, a trend toward endovascular surgery is emerging.…”

Section: Discussionmentioning

confidence: 99%

Experience of managing superior mesenteric artery aneurysm and its midterm follow-up results with 18 cases

Wang

Shu

et al. 2020

Vascular

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Objectives To characterize the clinical features, treatment, and prognosis of superior mesenteric artery aneurysms and provide evidence for clinical decision-making. Methods We retrospectively reviewed the diagnosis and treatment of 18 cases of superior mesenteric artery aneurysm admitted to our center from 2003 to 2020, including demographic data, risk factors, clinical manifestations, diagnosis, treatment strategies, and follow-up results. Results The average age of the patients was 49.1 years, and males accounted 83.3%. The development of the disease was associated with infection, hypertension, pancreatitis, and trauma, but no significant associations with atherosclerosis were noted by our results. Nine patients were diagnosed with true aneurysm, seven patients with pseudoaneurysm, and two patients with dissecting aneurysm. Rupture of aneurysm occurred in three patients (16.7%), and one of them died before surgery. The surgery success rate was 94.1%, and open surgery was performed on nine patients, endovascular surgery on three patients, and conservative treatment on three patients. The follow-up rate was 77.8% (14/18), and the average follow-up time was 48.2 months. The mortality and reintervention rate during follow-up was 0. The two-year patency rate of artificial vessels and covered stents was 50%. Conclusion The clinical manifestations and features of superior mesenteric artery aneurysms vary between patients. Careful evaluation of vascular anatomy and personalized treatment strategy are critical in the management of superior mesenteric artery aneurysms. Midterm follow-up results of superior mesenteric artery aneurysms are satisfactory.

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Single-Center Experience in the Treatment of Visceral Artery Aneurysms

Cited by 36 publications

References 21 publications

Current management strategies for visceral artery aneurysms: an overview

Current management strategies for visceral artery aneurysms: an overview

A Unique Presentation of Splenic Artery Aneurysm During Pregnancy

Experience of managing superior mesenteric artery aneurysm and its midterm follow-up results with 18 cases

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