title: Early and intermediate results of endovascular treatment of symptomatic and asymptomatic visceral artery aneurysms.
abstract: OBJECTIVE
  The treatment outcomes of symptomatic visceral artery aneurysms (SVAAs) have been sparsely characterized, with no clear comparisons between different treatment modalities. The purpose of this study was to review the outcomes of SVAAs and asymptomatic visceral artery aneurysms (ASVAAs) after endovascular treatment (ET).
  
  
  METHODS
  The records of all patients with visceral artery aneurysms (VAAs) at our center from March 2004 to December 2014 were retrospectively reviewed. Patient demographics, aneurysm characteristics, management, perioperative and long-term outcomes, and complications were recorded.
  
  
  RESULTS
  A total of 155 patients' records were reviewed; 106 patients (113 VAAs) were repaired with ET, including 27 symptomatic and 79 asymptomatic patients. The remaining 49 patients were treated with open surgery repair or conservative therapy. There was no significant difference of the diameters between SVAA and ASVAA (36.9 ± 15.3 mm vs 33.6 ± 36.1 mm, respectively; P = .746), and pseudoaneurysms were more common in the SVAA patients (13.8% vs 2.4%; P = .037). The most common presentation was abdominal pain. In the SVAA group, 17.2% of patients presented with rupture. The immediate technical success rates of SVAA and ASVAA repairs were 96.3% and 97.5%, respectively. The 30-day mortality rate was 2.8% for all VAAs; however, this was significantly higher in the SVAA group (11.1%) than in the ASVAA group (0%; P = .015). The perioperative complication rate was not statistically different between the two groups (P = .553). The median duration of follow-up was 39.1 ± 29.2 months (range, 1-112 months). Overall mortality in all VAA patients was 6.6%, and the direct and indirect aneurysm-related mortality was 3.8%. There was a statistical difference in the overall survival rate between the SVAA and ASVAA groups at 3 years (85.2% vs 97.5%; P = .044). The reintervention rate was 3.8%, and this tended to be higher for SVAAs (11.1%) than for ASVAAs (1.3%; P = .050).
  
  
  CONCLUSIONS
  ET for VAA is safe and effective; however, SVAA has a significantly higher 30-day mortality rate than ASVAA.
authors.affiliation: Department of Vascular Surgery, Institute of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Baolei
authors.initials: B
authors.lastname: Guo
authors.affiliation: Department of Vascular Surgery, Institute of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Daqiao
authors.initials: D
authors.lastname: Guo
authors.affiliation: Department of Vascular Surgery, Institute of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Vascular Surgery, Institute of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Chen
authors.affiliation: Department of Vascular Surgery, Institute of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Zhenyu
authors.initials: Z
authors.lastname: Shi
authors.affiliation: Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Luo
authors.affiliation: Department of Vascular Surgery, Institute of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Junhao
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Department of Vascular Surgery, Institute of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China. Electronic address: fu.weiguo@zs-hospital.sh.cn.
authors.forename: Weiguo
authors.initials: W
authors.lastname: Fu
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D017541:Aneurysm, False / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D017542:Aneurysm, Ruptured / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D058070:Asymptomatic Diseases; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D002681:China; D000072226:Computed Tomography Angiography; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000401:mortality; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014781:Viscera / Q000098:blood supply*