Surgical Treatment of True Superior Mesenteric Artery Aneurysms

Ruptured Mycotic Aneurysm of the Superior Mesenteric Artery: A Case Report

“…Infection is the least common cause of SMA aneurysms constituting only 0.7-3% of all aneurysms, and 18-50% of patients demonstrate negative cultures, similar to our patient [ 7 , 10 ]. If positive, cultures usually grow streptococcal or staphylococcal species [ 6 ]. Mycotic aneurysms result from the invasion of microbial organisms into the vessel wall, resulting in their destruction and dilation [ 7 ].…”

“…The management of mycotic SMA aneurysms includes medical, endovascular, and surgical therapies. Medical management alone is insufficient to prevent progression to aneurysmal rupture, which has a high mortality rate of 50% [ 6 , 7 ]. Hence, excision of the aneurysm has become standard practice, while endovascular options are reserved for poor surgical candidates [ 7 ].…”

“…Aneurysmal involvement of the visceral arteries is a rare condition that constitutes 0.1-2% of all aneurysms [5,6]. The splenic and hepatic arteries are more commonly involved and represent 60-80% and 20% of visceral aneurysms, respectively [7][8][9].…”

Transarterial Embolization of Visceral Artery Aneurysms

“…Before the advent of minimally invasive transcatheter treatments, the primary options were surgical clamping, vessel reconstruction, or resection of the affected vessel. While these methods remain prevalent for mycotic aneurysms, percutaneous endovascular embolization (PAE) (28) has gained prominence for ruptured aneurysms, exhibiting a 30-day mortality rate of 6.7% compared to 0% for non-ruptured aneurysms (30)(31)(32)(33). Interdisciplinary guidelines now guide the elective treatment decisions for incidental aneurysms, and embolization techniques have evolved with the introduction of new catheters and guide wires.…”