Systematic Review and Single-Center Experience for Endovascular Management of Visceral and Renal Artery Aneurysms.
OBJECTIVE
To report a systematic review of endovascular management of visceral and renal artery aneurysms (VRAA) and results at a tertiary referral center.


METHODS
A literature review was performed via a comprehensive electronic search of PubMed, MEDLINE, EMBASE, and Cochrane databases, followed by retrospective analysis of all VRAAs treated at a tertiary referral center from January 1999 to December 2015.


RESULTS
The systematic review included 22 studies published between 2005 and 2016 describing endovascular treatment of VRAA. In the systematic review cohort, 646 aneurysms (432 true, 151 false, 63 unclassified) were treated using endovascular methods with 93.2% technical success, 99.3% visceral preservation, 3.5% major complication (classified based on Society of Interventional Radiology criteria), 1.5% 30-day periprocedural mortality, and 4.6% reintervention rates. In the local cohort, 19 aneurysms (12 true, 7 false) were treated with 100% technical success, 94.7% visceral preservation, and 10.5% major complication rates. There was no periprocedural mortality. Over mean follow-up of 31.9 months (range, 2-170 months), there were 2 aneurysm reperfusions, which required no further treatment. Results incorporating data from the systematic review and local cohorts (665 aneurysms) showed 93.6% technical success, 99.1% visceral preservation, 3.7% major complication, 1.5% periprocedural mortality, and 4.4% reintervention rates.


CONCLUSIONS
Endovascular treatment of VRAA is associated with excellent technical success and visceral preservation rates. Major complication and periprocedural mortality rates are comparatively low. A few VRAA (4.4%) required future reintervention suggesting that imaging follow-up is essential after initial treatment.
Department of Interventional Radiology, Beaumont Hospital and Royal College of Surgeons in Ireland, Beaumont Road, Dublin 9, Ireland.
Hong Kuan
HK
Kok
Department of Interventional Radiology, Beaumont Hospital and Royal College of Surgeons in Ireland, Beaumont Road, Dublin 9, Ireland; School of Medicine, Faculty of Health, Deakin University, Victoria, Australia.
Hamed
H
Asadi
Department of Interventional Radiology, Beaumont Hospital and Royal College of Surgeons in Ireland, Beaumont Road, Dublin 9, Ireland.
Mark
M
Sheehan
Department of Interventional Radiology, Beaumont Hospital and Royal College of Surgeons in Ireland, Beaumont Road, Dublin 9, Ireland.
Mark F
MF
Given
Department of Interventional Radiology, Beaumont Hospital and Royal College of Surgeons in Ireland, Beaumont Road, Dublin 9, Ireland. Electronic address: mlee@rcsi.ie.
Michael J
MJ
Lee
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D005260:Female; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D014781:Viscera / Q000098:blood supply*