Ten-Year Experience with Repair of Visceral Artery Aneurysms

Abstract

The aim of this study is to evaluate midterm Results obtained with surgical and endovascular treatment of visceral artery aneurysms (VAA) and to describe the open and endovascular techniques used to repair these aneurysms. A retrospective review of patients undergoing VAA repair at a single academic tertiary medical center was performed from 2008 to 2017. Patient demographics, aneurysm characteristics, surgical management, and patient outcomes were evaluated. Twenty-seven patients (13 males, 14 females) with a median age of 61 ± 12.9 years underwent a total of 28 surgical or endovascular repairs of VAAs. The pathology of VAAs included 11 splenic artery aneurysms (39.3%), 6 renal artery aneurysms (21.4%), 5 hepatic artery aneurysms (17.9%), as well as 2 aneurysms of the pancreaticoduodenal artery, celiac artery, and superior mesenteric artery, respectively (7.1%). Four patients (14.8%) presented with symptoms of back pain or abdominal pain, while the majority aneurysms were incidentally found (85.2%). Seventeen aneurysms were repaired by open surgical techniques with ligation, primary repair, or bypass, while 11 aneurysms were treated with endovascular techniques with stent grafts and coiling. All aneurysms were intact at the time of repair with a median size of 2.3 ± 2.2 cm. One-year survival was 100% for patients undergoing open or endovascular repair. Only one patient among the endovascular repair group required reintervention for aneurysmal growth noted on surveillance imaging. The surgical and endovascular techniques used are described. Excellent midterm survival is feasible with open or endovascular repair of VAAs. Due to the potential need for reintervention, long term follow-up imaging is suggested.