title: Stent-graft repairs of visceral and renal artery aneurysms are effective and result in long-term patency.
abstract: OBJECTIVE
  To report on the long-term outcomes of endovascular exclusion of visceral and renal artery aneurysms with the use of stent-grafts.
  
  
  METHODS
  Nineteen consecutive patients (mean age, 59 y ± 16 [standard deviation]) with a total of 19 visceral artery aneurysms (VAAs; hepatic, n = 6; celiac, n = 4; renal, n = 4; splenic, n = 3; and superior mesenteric, n = 2) were electively (n = 9) or emergently (n = 10) treated with a variety of stent-grafts. The etiology of aneurysms was variable: postoperative (n = 9), infectious (n = 3), idiopathic (n = 4), Ehlers-Danlos syndrome (n = 2), and α1-antitrypsin deficiency (n = 1). The patients were followed up with clinical examinations and computed tomographic (CT) angiography.
  
  
  RESULTS
  No patient was lost to follow-up. The in-hospital mortality rate was 11% (n = 2). Three patients died of cancer after successful VAA treatment. At the last follow-up, the remaining 14 patients were alive and well. Three patients refused follow-up CT angiography. CT angiography demonstrated stent-graft patency at a mean follow-up of 28 months (range, 2-100 mo) in nine of 11 remaining patients (82%) and thrombosis in two patients (one with a splenic and one with a renal artery stent-graft). These events were asymptomatic. All aneurysms decreased in size. Late repeat intervention was performed to treat a celiac restenosis in a patient with a hepatic stent-graft.
  
  
  CONCLUSIONS
  Irrespective of their etiology and acuteness, VAAs can be treated with stent-grafts, with an excellent clinical long-term outcome and a high patency rate.
authors.affiliation: Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Künzle
authors.forename: Michael
authors.initials: M
authors.lastname: Glenck
authors.forename: Gilbert
authors.initials: G
authors.lastname: Puippe
authors.forename: Erik
authors.initials: E
authors.lastname: Schadde
authors.forename: Dieter
authors.initials: D
authors.lastname: Mayer
authors.forename: Thomas
authors.initials: T
authors.lastname: Pfammatter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency; D014781:Viscera / Q000098:blood supply*