title: Early and Intermediate Results of Elective Endovascular Treatment of True Visceral Artery Aneurysms.
abstract: BACKGROUND
  To retrospectively analyze early and follow-up results of endovascular management of visceral artery aneurysms (VAAs) in a single-center experience.
  
  
  METHODS
  From 2007 to June 2013, 26 consecutive elective endovascular interventions for VAAs were performed in 26 patients; preoperative, intraoperative, 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 17 patients, common hepatic artery in 3 patients, renal artery and pancreaticoduodenal artery in 2 cases each, and gastroduodenal artery and celiac trunk in one case each. All the lesions were asymptomatic, and the mean diameter was 22.8 mm. Interventions consisted in coiling in 19 cases; in 4 patients a covered stent was placed, whereas the remaining 3 patients had a multilayer stent. Technical success was 89%. There were no perioperative deaths; 1 patient with splenic artery aneurysm had coils migration with symptomatic splenic infarction and underwent successful redo coils packing. Median duration of follow-up was 18 months. During follow-up, 1 aneurysm-unrelated death occurred. One asymptomatic thrombosis of a treated vessel was recorded, with a 2-year estimated patency rate of 91%. Mean aneurysmal diameter at the latest follow-up was 20.2 mm (P = 0.001 in comparison with preoperative values; 95% confidence interval 1.9-5.2). Complete exclusion of the aneurysm occurred in all but 1 patient, who had a limited increasing in the diameter of its splenic aneurysmal sac after coiling. Another patient developed a more distal aneurysm of the splenic artery after 24 months. No reinterventions were required. Freedom from aneurysm-related complications at 2 years was 72.9% (Standard Error, 0.09).
  
  
  CONCLUSIONS
  In our experience, endovascular treatment of VAA, when feasible, provided excellent perioperative results with low rates of complications and reinterventions. Even if the risk of developing aneurysm-related complications during follow-up is substantial, most of them can be watched without the need for repeated interventions.
authors.affiliation: Department of Vascular Surgery, University of Florence, Florence, Italy. Electronic address: dorigow@unifi.it.
authors.forename: Walter
authors.initials: W
authors.lastname: Dorigo
authors.affiliation: Department of Vascular Surgery, University of Florence, Florence, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Pulli
authors.affiliation: Department of Vascular Surgery, University of Florence, Florence, Italy.
authors.forename: Leonidas
authors.initials: L
authors.lastname: Azas
authors.affiliation: Department of Vascular Surgery, University of Florence, Florence, Italy.
authors.forename: Aaron
authors.initials: A
authors.lastname: Fargion
authors.affiliation: Department of Vascular Surgery, University of Bari, Bari, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Angiletta
authors.affiliation: Department of Vascular Surgery, University or Rome Tor Vergata, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pratesi
authors.affiliation: Department of Vascular Surgery, University of Florence, Florence, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Alessi Innocenti
authors.affiliation: Department of Vascular Surgery, University of Florence, Florence, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Pratesi
mesh_terms: D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D017558:Elective Surgical Procedures; D057510:Endovascular Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014781:Viscera / Q000098:blood supply*; D055815:Young Adult