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