title: Treatment options for visceral artery aneurysms: ten year experience.
abstract: OBJECTIVE
  Open surgical repair (OSR) and endovascular techniques (ET) are both described in the literature for treating visceral artery aneurysms (VAAs). Aim of this study is to report a two-center experience of patients treated for a VAA using either OSR or ET, analyzing perioperative outcomes.
  
  
  METHODS
  Clinical data of 32 VAAs in 32 patients treated between January 2001 and May 2011 were retrospectively reviewed and outcomes analyzed.
  
  
  RESULTS
  Eighteen patients were men (56.3%). Median age was 64 years (range 26-79). Sixteen aneurysms were symptomatic: half of them were ruptured causing hemoperitoneum or gastrointestinal bleeding. ET were employed in 19 cases (59%) using covered stents (7 patients), coil embolization (5), plug placement (1), thrombin injection (2) and multiple associated techniques (4). OSR consisted in aneurysmectomy with end to end anastomoses (5 patients) or interposition graft (1), aneurysm ligation (4), splenectomy (2). One patient died during open surgery for hemoperitoneum due to VAA rupture (3%). OSR and ET had similar perioperative complication rates (5.2% vs. 15.3%, P=0.76). OSR had a longer in-hospital stay than ET (8 vs. 4 days, P=0.04). The presence of pancreatitis and alcohol abuse were more frequent in patients who presented with VAAs rupture. Clinical presentation with hemoperitoneum or aneurysm rupture were associated with higher mortality, regardless of the type of treatment.
  
  
  CONCLUSIONS
  Both OSR and ET offered a safe way to treat VAAs in our experience.
authors.affiliation: Division of Vascular Surgery, Ospedale San Carlo Borromeo, Milan, Italy - michele.carmo@unimi.it.
authors.forename: D
authors.initials: D
authors.lastname: Mazzaccaro
authors.forename: M
authors.initials: M
authors.lastname: Carmo
authors.forename: G
authors.initials: G
authors.lastname: Nano
authors.forename: I
authors.initials: I
authors.lastname: Barbetta
authors.forename: A M
authors.initials: AM
authors.lastname: Settembrini
authors.forename: M T
authors.initials: MT
authors.lastname: Occhiuto
authors.forename: S
authors.initials: S
authors.lastname: Stegher
authors.forename: R
authors.initials: R
authors.lastname: Dallatana
authors.forename: G
authors.initials: G
authors.lastname: Malacrida
authors.forename: P G
authors.initials: PG
authors.lastname: Settembrini
mesh_terms: D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000175:diagnosis / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D001807:Blood Vessel Prosthesis; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D007558:Italy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D014781:Viscera / Q000098:blood supply*