title: Visceral artery aneurysms, an experience on 32 cases in a single center: treatment from surgery to multilayer stent.
abstract: Between 2000 and 2010, 32 patients (17 males; mean age: 64.7 [range: 18-85] years) with visceral artery aneurysms (VAAs) were treated in our center. The site of aneurysmal disease was: splenic artery (18), hepatic artery (5), superior mesenteric artery (3), pancreaticoduodenal artery (3), celiac axis (2), and gastroduodenal (1). Six patients (18.75%) presented with an aneurysm rupture. Nine cases received an endovascular treatment. Primary technical success was achieved in six patients. Failures included one case of immediate stent occlusion, one stent migration, and one failed attempt of embolization. In 24 cases, the surgical treatment was performed successfully. The total survival rate was 90.6% (in urgency: 75%; in election: 95.8%). A follow-up period of 34.7 months (range: 2-117 months) showed good results. Because of the potential risk of rupture, VAAs should be treated. A new endovascular technology based on a multilayer stent could provide us with a new alternative to VAA treatment, guaranteeing both aneurysmatic sac thrombosis and the correct perfusion of the organs. However, this new technology is not suitable for all aneurysms and requires a specific training and learning curve. In subjects with a low surgical risk, surgery guarantees a definitive and long-lasting repair with a good organ perfusion.
authors.affiliation: Vascular and Endovascular Surgery Unit, Mauriziano Umberto I Hospital, Turin, Italy. emaferrero@libero.it
authors.forename: Emanuele
authors.initials: E
authors.lastname: Ferrero
authors.forename: Michelangelo
authors.initials: M
authors.lastname: Ferri
authors.forename: Andrea
authors.initials: A
authors.lastname: Viazzo
authors.forename: Alessandro
authors.initials: A
authors.lastname: Robaldo
authors.forename: Paolo
authors.initials: P
authors.lastname: Carbonatto
authors.forename: Alberto
authors.initials: A
authors.lastname: Pecchio
authors.forename: Andrea
authors.initials: A
authors.lastname: Chiecchio
authors.forename: Franco
authors.initials: F
authors.lastname: Nessi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D017542:Aneurysm, Ruptured / Q000601:surgery; D001158:Arteries / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D016009:Chi-Square Distribution; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D005260:Female; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D015996:Survival Rate; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014781:Viscera / Q000098:blood supply*; D055815:Young Adult