Visceral Artery Aneurysm: Risk Factor Analysis and Therapeutic Opinion

Huang, Yao‐Kuang; Hsieh, Hsiao-Yun; Tsai, Feng‐Chun; Chang, Su-Wei; Lu, Minghao; Ko, Po‐Jen

doi:10.1016/j.ejvs.2006.09.016

Cited by 121 publications

(75 citation statements)

References 20 publications

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“…Such a complementary combination has also been reported in the literature. 5 As in most of the reported series, splenic artery was the most commonly involved one (44%) in our patient population, followed by hepatic (25%) and superior mesenteric (13%) arteries. Interestingly, 4/6 patients with presented as an emergency.…”

Section: Discussionmentioning

confidence: 75%

“…In the asymptomatic state treatment should be provided for pseudo-, splenic, or renal aneurysms of any size in women of childbearing therapeutic choice: surgery is the conventional treatment, Angiographic embolization of the aneurysms is an emerging option, with constantly improving results. 5 However, the ultimate choice depends upon factors like availability of services, surgical practice, and clinical presentation. In a report from Italy, all but one of the 59 pseudoaneurysms in 55 patients were treated with surgery with excellent results.…”

Section: Discussionmentioning

confidence: 99%

“…6 A retrospective review of 41 patients, on the other hand, showed that endovascular intervention provides compatible, even better early postoperative outcomes for visceral artery aneurysms, when compared to surgery. 5 Conventional open surgical excision and repair should be considered when patients present with hypotension or when collateral circulation is not adequate to maintain perfusion to the end organ, risking ischemia and infection. 2 Endovascular therapy, with the main intent of isolating the aneurysm from circulation while maintaining circulation to end organ, can be accomplished by multiple techniques.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Visceral artery aneurysms: an institutional review

Sapkota¹,

Ghimire

Lakhey

et al. 2017

J. Soc. Surg. Nepal

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Visceral artery aneurysms: an institutional review

Sapkota¹,

Ghimire

Lakhey

et al. 2017

J. Soc. Surg. Nepal

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“…4,[6][7][8]21 For example, Marone et al have reported that the overall 10-year survival rate after the treatment of VA is 68%. 8 …”

Section: Discussionmentioning

confidence: 99%

Mini-Laparotomy for Superior Mesenteric Artery Aneurysm Due to Takayasu's Arteritis

Matsumoto

Ishizuka

Iso

et al. 2015

International Surgery

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Superior mesenteric artery aneurysm (SMAA) is reported to be the third-most common type of visceral aneurysm (VA), accounting for 5% of all VAs. The etiology of SMAA is commonly thought to be infection, and it usually exists in the proximal part of the superior mesenteric artery, which is suitable for endovascular treatment. We herein report an extremely rare case of the distal part of SMAA caused by Takayasu's arteritis (TA), which was successfully resected using a mini-laparotomy method without impairing the intestinal blood supply. A 51-year-old woman was admitted to our hospital with sustained fever and lower back pain. Physical examination showed that she had a discrepancies in blood pressure between both arms. Contrast-enhanced wholebody computed tomography showed stenosis of the thoracic aorta and an aneurysm located in the distal part of the superior mesenteric artery. The diameter of the aneurysm was 4.5 cm. The aneurysm was resected via 4-cm mini-laparotomy, and the vascularity of the intestine was successfully preserved. The postoperative course was uneventful, and the patient was diagnosed as having TA based on both clinical and pathologic findings. Additional corticosteroid therapy was started to treat the arteritis, and at 3-month followup she was without critical incidents. Mini-laparotomy is a safe and less-invasive approach to treat SMAA, especially when the lesion is located in the distal part of the artery.

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“…Endovascular treatment of visceral aneurysm is an alternative to conventional surgery with lower procedural mortality and morbidity, reducing aneurysm related symptoms with high technical success rates. 5) Most favorable morphology for endovascular treatment includes saccular aneurysms, aneurysms with adequate collateral flow, and aneurysms of vessels that are not the only provider of blood supply to the organ. 6) Regarding the hemodynamics, this case could be able to treat with endovascular treatment.…”

Section: Disclosure Statementmentioning

confidence: 99%

Surgical Treatment of a Giant Right Hepatic Artery Aneurysm with an Aberrant Left Hepatic Artery: Report of a Case

Shukuzawa

Toya

Fukushima

et al. 2015

Annals of Vascular Diseases

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Hepatic artery aneurysms are rare. We describe a case of a successful surgical treatment of a giant hepatic aneurysm without revascularization. A 63-year-old female was admitted to our department complaining of abdominal pain. Computed tomography showed a thrombosed hepatic artery aneurysm measuring 5.5 cm in diameter. A celiac angiography revealed an aberrant left hepatic artery and a right hepatic aneurysm. Liver blood flow and the right hepatic aneurysm were visualized via collateral pathway from the aberrant left hepatic artery. We performed an aneurysmorrhaphy without revascularization. Postoperative course was uneventful and the patient is doing well 3 months after surgery. Keywords: hepatic artery, aneurysm, surgical treatmentHere, we report the surgical treatment of a giant right HAA (RHAA) with an aberrant left hepatic artery, which grew up to 6.0 × 5.5 cm in diameter, in spite that the aneurysm was thrombosed. Case ReportIn July 2013, a 63-year-old female patient was admitted to our emergency department with sudden abdominal pain. The patient had undergone coronary artery bypass graft for angina pectoris and Dor procedure for left ventricular aneurysm. Because of those operations, she required warfarin. She had no history of cholecystitis, pancreatitis, previous abdominal operation and trauma. Abdominal examination revealed a large mass in right upper quadrant and moderate discomfort with deep palpation in the epigastric area. The laboratory data were within normal limit. CT showed an unruptured thrombosed HAA measuring 5.3 × 5.3 cm in diameter. Her symptom improved gradually with administration of antiulcer drugs in a few days, therefore the aneurysm was observed with CT twice a year. Until in July 2014, diameter of the aneurysm did not change. In Feb 2015, she was readmitted to our department with sudden abdominal pain. In this time, she had tender mass in right upper quadrant, and CT showed that the aneurysm grew up to 6.0 × 5.5 cm in diameter without enhancement of contrast medium (Fig. 1). A celiac angiography through the femoral artery was performed. The angiography revealed a giant RHAA. An origin of the right hepatic artery was calcified and occluded and the left hepatic artery arose from the celiac trunk. Moreover, blood flow in a RHAA was visualized via collateral blood flow from the left hepatic artery in the late phase angiogram (Fig. 2). The aneurysm was indicated for operation because of impending rupture.At operation, the aneurysm was exposed through a hokey-stick incision. The left hepatic artery, the common hepatic artery (CHA) and the gastroduodenal artery (GDA) were under control (Fig. 3A). We clamped CHA and GDA, and incised the aneurysm longitudinally. After removing the thrombus in the aneurysm, the collateral

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Visceral Artery Aneurysm: Risk Factor Analysis and Therapeutic Opinion

Abstract: The endovascular intervention provides compatible, even better early postoperative outcomes for visceral artery aneurysms to surgery. Concomitant malignancy was the major determinant of visceral artery aneurysms, both in-hospital death and survival.

Cited by 121 publications

References 20 publications

Visceral artery aneurysms: an institutional review

Visceral artery aneurysms: an institutional review

Mini-Laparotomy for Superior Mesenteric Artery Aneurysm Due to Takayasu's Arteritis

Surgical Treatment of a Giant Right Hepatic Artery Aneurysm with an Aberrant Left Hepatic Artery: Report of a Case

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