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 PS88. Early and Mid-Term Results of Endovascular Treatment of Visceral Artery Aneurysms

Walter Dorigo, Raffaele Pulli, Irene Spina, Leonidas Azas, Aaron Fargion, Alessandro Alessi Innocenti, Carlo Pratesi
Vascular Surgery, University of Florence, Florence, Italy.


OBJECTIVES: To retrospectively analyze early and follow-up results of endovascular management of visceral artery aneurysms in a single centre experience.

METHODS: From January 2007 to December 2012, 21 consecutive endovascular interventions for visceral artery aneurysms were performed in 21 patients; pre, intra and postoperative data were prospectively collected in a dedicated database. Early (<30 days) and follow-up results were evaluated.

RESULTS: The site of aneurysm was splenic artery in 16 patients and common hepatic artery in 3 patients, while the remaining two patients had gastroduodenal and celiac aneurysms, respectively. All the lesions were asymptomatic, and the mean diameter was 23.9mm. Interventions consisted in coil embolization in 14 cases; in 4 patients a covered stent was placed, while the remaining three patients had a multilayer stent. Technical success was 91%. There were no perioperative deaths; 1 patient with splenic artery aneurysm had coils migration with symptomatic splenic infarction and underwent successful redo embolization. Median duration of follow-up was 20 months. During follow-up, one aneurysm-unrelated death occurred. Neither thrombosis of the treated artery nor reintervention were recorded. Mean aneurismal diameter at the latest follow-up was 20.2mm (p=0.001 in comparison with preoperative values; 95% (CI 1,7-5.5). Complete exclusion of the aneurysm occurred in all but 1 patient, who had a limited increasing in the diameter of its splenic aneurismal sac after coil embolization. Another patient developed a more distal aneurysm of the splenic artery after 24 months. Freedom from aneurysm-related complications at 2 years was 70% (SE 0.10).

CONCLUSIONS: In our experience, endovascular treatment of visceral artery aneurysm is feasible with low perioperative morbidity. Follow-up results are satisfactory; however, the risk of developing aneurysm-related complications warrants the need for prolonged surveillance

AUTHOR DISCLOSURES: A. Alessi Innocenti: Nothing to disclose; L. Azas: Nothing to disclose; W. Dorigo: Nothing to disclose; A. Fargion: Nothing to disclose; C. Pratesi: Nothing to disclose; R. Pulli: Nothing to disclose; I. Spina: Nothing to disclose.
 
Posted April 2013

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