The natural history of splanchnic artery aneurysms and outcomes after operative intervention

Corey, Michael R.; Ergül, Emel; Cambria, Richard P.; English, Sean; Patel, Virendra I.; Lancaster, Robert T.; Kwolek, Christopher J.; Conrad, Mark F.

doi:10.1016/j.jvs.2015.10.066

Cited by 74 publications

(76 citation statements)

References 29 publications

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“…The intervention-based total morbidity rate of 10 % (8 % requiring treatment) for all interventions of the examined population showed good comparability with other studies (3 -8 %) [8,22,23]. The perioperative morbidity of conventional surgical therapy in terms of surgery-associated complications in a period of up to 30 days after the operation of 7 -13 % is also comparable [15,24,25]. The study by Hemp and Sabri showed that there is no significant difference between endovascular and surgical therapy regarding periprocedural morbidity and mortality but that there was a significant reduction in the length of the hospital stay after interventional therapy [10].…”

Section: Discussionsupporting

confidence: 61%

Visceral Artery Aneurysms and Pseudoaneurysms: Retrospective Analysis of Interventional Endovascular Therapy of 43 Aneurysms

Ruhnke¹,

Kröncke²

2017

Fortschr Röntgenstr

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ABSTR AC TPurpose To evaluate the results of interventional endovascular therapy of incidental and symptomatic visceral artery aneurysms in the elective and emergency situation.Materials and Methods 43 aneurysms in 38 patients (19 female, 19 male, mean age: 57 ± 16 years [18 -82]) were treated between 2011 and 2015. The characteristics of the aneurysms (true vs. false aneurysm, size, etiology, location, symptoms) were considered. Furthermore, we evaluated the intervention with respect to technical success, embolic/occlusive agents used, therapy-associated complications and postinterventional follow-up.Results 23 true aneurysms (maximum diameter: 22 ± 18 mm [11 -67 mm]) and 20 false aneurysms (maximum diameter: 9 ± 33 mm [3 -150 mm]) were evaluated. The splenic (n = 14) and renal arteries (n = 18) were most frequently affected. The etiology was most commonly degenerative-atherosclerotic (47 %) or iatrogenic post-operative (19 %). 18/48 interventions were performed due to active bleeding. False aneurysms were associated significantly more often with active bleeding (63 vs. 25 %, p = 0.012). 41/48 treatments were technically successful. Re-intervention was necessary 6 times. In 2 cases the endovascular approach did not succeed. There was a complication rate of 10 %, whereby only 4 minor and 1 major complications occurred. No patient suffered from permanent sequelae. Aneurysms were primarily treated by using coils and if necessary additional embolic agents (liquid embolic agent or vascular plugs) (75 %). In the follow-up period, reperfusion of treated aneurysms occurred at a rate of 7 % (n = 3). ConclusionInterventional endovascular therapy of visceral artery aneurysms is safe and effective in the elective treatment of incidental aneurysms as well as in significantly more frequent hemorrhaging false aneurysms in the emergency situation. Key points▪ Interventional endovascular therapy of visceral artery aneurysms is safe and effective. ▪ In more than 60 % of cases visceral artery pseudoaneurysms are associated significantly more often with a history of bleeding or acute bleeding. Hence, there is a need for (interventional) therapy even in small pseudoaneurysms. ▪ Follow-up seems to be useful to detect reperfusion as manifestation of treatment failure. This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.tischen Aneurysmen der viszeralen Gefäße in der elektiven sowie der Notfallsituation. Material und Methoden

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Section: Discussionsupporting

confidence: 61%

Visceral Artery Aneurysms and Pseudoaneurysms: Retrospective Analysis of Interventional Endovascular Therapy of 43 Aneurysms

Ruhnke¹,

Kröncke²

2017

Fortschr Röntgenstr

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“…Bei einer interventionsbedingten Gesamtmorbidität von 10 % (8 % therapiebedürftig) im Rahmen aller Interventionen des untersuchten Kollektivs zeigt sich eine gute Vergleichbarkeit mit anderen Untersuchungen (3 -8 %) [9,22,23]. Die perioperative Morbidität der konventionellen chirurgischen Therapie im Sinne operationsassoziierter Komplikationen ist in einem Zeitraum von bis zu 30 Tagen nach der Operation mit 7 -13 % ebenfalls vergleichbar [15,24,25]. Die Übersichtsarbeit von Hemp u. Sabri hat gezeigt, dass es keinen signifikanten Unterschied zwischen endovaskulärer und chirurgischer Therapie bzgl.…”

Section: Komplikationsrateunclassified

Aneurysmen und Pseudoaneurysmen viszeraler Arterien – interventionelle Therapie

Ruhnke¹,

Kröncke²

2018

Gefäßmedizin Scan

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Purpose To evaluate the results of interventional endovascular therapy of incidental and symptomatic visceral artery aneurysms in the elective and emergency situation. Materials and Methods 43 aneurysms in 38 patients (19 female, 19 male, mean age: 57???16 years [18???82]) were treated between 2011 and 2015.?The characteristics of the aneurysms (true vs. false aneurysm, size, etiology, location, symptoms) were considered. Furthermore, we evaluated the intervention with respect to technical success, embolic/occlusive agents used, therapy-associated complications and postinterventional follow-up. Results 23 true aneurysms (maximum diameter: 22???18?mm [11???67?mm]) and 20 false aneurysms (maximum diameter: 9???33?mm [3???150?mm]) were evaluated. The splenic (n?=?14) and renal arteries (n?=?18) were most frequently affected. The etiology was most commonly degenerative-atherosclerotic (47?%) or iatrogenic post-operative (19?%). 18/48 interventions were performed due to active bleeding. False aneurysms were associated significantly more often with active bleeding (63 vs. 25?%, p?=?0.012). 41/48 treatments were technically successful. Re-intervention was necessary 6 times. In 2 cases the endovascular approach did not succeed. There was a complication rate of 10?%, whereby only 4 minor and 1 major complications occurred. No patient suffered from permanent sequelae. Aneurysms were primarily treated by using coils and if necessary additional embolic agents (liquid embolic agent or vascular plugs) (75?%). In the follow-up period, reperfusion of treated aneurysms occurred at a rate of 7?% (n?=?3). Conclusion Interventional endovascular therapy of visceral artery aneurysms is safe and effective in the elective treatment of incidental aneurysms as well as in significantly more frequent hemorrhaging false aneurysms in the emergency situation.

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“…92 % über im Mittel 36 Monate stabil waren (2-155 Monate!). Lediglich 5,8 % zeigten eine Ruptur [5].…”

Section: Behandlungsindikationunclassified

“…Insgesamt liegt die Morbiditätsrate periinterventionell zwischen 3 und 8 % [27][28][29]. Diese liegt damit unterhalb der publizierten Daten für die perioperative Morbidität offen chirurgischer Therapien von 7-13 % [5,21,30].…”

Section: Pro Endovaskuläre Therapieunclassified

Endovaskuläre Therapie von Viszeralarterienaneurysmata – geht das immer?

et al. 2018

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ZusammenfassungEchte Viszeralarterienaneurysmata (VAA) und Viszeralarterienpseudoaneurysmata (VAPA) treten im Stromgebiet des Truncus coeliacus, der A. mesenterica superior und der A. mesenterica inferior auf. Neben der operativen Therapie stellt die endovaskuläre Versorgung viszeraler Aneurysmata sowie Pseudoaneurysmata eine interventionelle Alternativmethode dar, die sich in den letzten beiden Dekaden sprunghaft entwickelt hat und in vielen Zentren als Methode der ersten Wahl gilt. Das Verfahren zeichnet sich durch eine hohe technische Erfolgsrate bei niedriger Komplikationsrate aus. Der vorliegende Artikel zeigt die Grundprinzipien der endovaskulären Versorgung auf und diskutiert den Stellenwert sowie die Limitierungen des Verfahrens.

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The natural history of splanchnic artery aneurysms and outcomes after operative intervention

Cited by 74 publications

References 29 publications

Visceral Artery Aneurysms and Pseudoaneurysms: Retrospective Analysis of Interventional Endovascular Therapy of 43 Aneurysms

Visceral Artery Aneurysms and Pseudoaneurysms: Retrospective Analysis of Interventional Endovascular Therapy of 43 Aneurysms

Aneurysmen und Pseudoaneurysmen viszeraler Arterien – interventionelle Therapie

Endovaskuläre Therapie von Viszeralarterienaneurysmata – geht das immer?

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