Rupture Risk and Etiology of Visceral Artery Aneurysms and Pseudoaneurysms: A Single-Center Experience

Vasc Endovascular Surg. 2016 Jan;50(1):10-5. doi: 10.1177/1538574415627868.

Abstract

Background: The aim of this study was to analyze differences in rupture risk and etiology of visceral artery aneurysms (VAAs) and visceral artery pseudoaneurysms (VAPAs) in a single-center experience.

Materials and methods: We retrospectively reviewed all patients with a VAA or VAPA after treatment by open surgical or endovascular repair (ER) in our institution. Patient history, treatment details, and outcome were recorded and analyzed.

Results: From January 1996 to April 2014, 29 (12 women) patients with 33 aneurysms (26 VAAs and 7 VAPAs) were treated in elective and urgent settings by open repair or ER. Etiology was quite different, most common was atherosclerosis (61.5%) in VAA and chronic pancreatitis (85.7%) in VAPA. Rupture rate was 19.2% in VAA and 42.9% in VAPA, whereas mean size of ruptured VAA was 4.4 cm and of ruptured VAPA was 2 cm. Open repair (suture, ligation, and aneurysmectomy with or without arterial reconstruction) and ER (coil embolization in the packing technique) were performed in half of all cases. After follow-up (72-month VAA and 82-month VAPA), aneurysm-free survival was reported to be 95% in VAA and 100% in VAPA.

Conclusion: Chronic pancreatitis seems to be a prominent risk factor for the development of VAPA in this single-center experience. Modern endovascular techniques with promising short- and long-term results could broaden indications to treat asymptomatic VAA and VAPA.

Keywords: chronic pancreatitis; rupture risk; visceral artery aneurysms; visceral artery pseudoaneurysm.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aneurysm / diagnostic imaging
  • Aneurysm / etiology*
  • Aneurysm / surgery
  • Aneurysm, False / diagnostic imaging
  • Aneurysm, False / etiology*
  • Aneurysm, False / surgery
  • Aneurysm, Ruptured / diagnosis
  • Aneurysm, Ruptured / etiology*
  • Aneurysm, Ruptured / surgery
  • Arteries* / diagnostic imaging
  • Arteries* / surgery
  • Elective Surgical Procedures
  • Emergencies
  • Endovascular Procedures
  • Female
  • Germany
  • Humans
  • Male
  • Middle Aged
  • Pancreatitis, Chronic / complications
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome
  • Vascular Surgical Procedures
  • Viscera / blood supply*