Visceral Artery Aneurysms: Review of Current Management Options

Author(s):  
Ulka Sachdev-Ost
Surgery Today ◽  
2019 ◽  
Vol 50 (1) ◽  
pp. 38-49 ◽  
Author(s):  
Hideaki Obara ◽  
Matsubara Kentaro ◽  
Masanori Inoue ◽  
Yuko Kitagawa

Abstract Visceral artery aneurysms (VAAs) are rare and affect the celiac artery, superior mesenteric artery, and inferior mesenteric artery, and their branches. The natural history of VAAs is not well understood as they are often asymptomatic and found incidentally; however, they carry a risk of rupture that can result in death from hemorrhage in the peritoneal cavity, retroperitoneal space, or gastrointestinal tract. Recent advances in imaging technology and its availability allow us to diagnose all types of VAA. VAAs can be treated by open surgery, laparoscopic surgery, endovascular therapy, or a hybrid approach. However, there are still no specific indications for the treatment of VAAs, and the best strategy depends on the anatomical location of the aneurysm as well as the clinical presentation of the patient. This article reviews the literature on the etiology, clinical features, diagnosis, and anatomic characteristics of each type of VAA and discusses the current options for their treatment and management.


Surgery ◽  
1996 ◽  
Vol 120 (4) ◽  
pp. 627-634 ◽  
Author(s):  
Sandra C. Carr ◽  
William H. Pearce ◽  
Robert L. Vogelzang ◽  
Walter J. McCarthy ◽  
Albert A. Nemcek ◽  
...  

2015 ◽  
Author(s):  
Louise A. Corle ◽  
Erica L. Mitchell

Although rare, visceral artery aneurysms are being increasingly identified with the widespread use of advanced imaging techniques. Their incidence, based on routine autopsies, has been estimated at 0.01 to 0.2% but is thought to be increasing with the rise in percutaneous biliary procedures, endovascular chemoembolization therapies, liver transplantation, arterial trauma secondary to laparoscopic manipulation of vessels, and a trend toward nonoperative management of blunt liver trauma. The morbidity and mortality associated with visceral aneurysms remain high—up to 22% in some reports. Therefore, early recognition and treatment prior to rupture are a priority. Management is evolving and includes open repair, laparoscopic and robotic-assisted repair, and a more important role for endovascular therapies. This review covers splenic artery aneurysms, hepatic artery aneurysms, superior mesenteric artery aneurysms, celiac artery aneurysms, and gastroduodenal and pancreaticoduodenal artery aneurysms. Tables highlight the estimated frequency of aneurysms by anatomic distribution, current management options, etiology of splanchnic artery aneurysms, average visceral artery diameters, and preoperative imaging options. Angiographic images and intraoperative photos are provided. This review contains 12 figures, 5 tables, and 25 references.


Surgery Today ◽  
2020 ◽  
Vol 50 (3) ◽  
pp. 320-320
Author(s):  
Hideaki Obara ◽  
Matsubara Kentaro ◽  
Masanori Inoue ◽  
Yuko Kitagawa

The article Current management strategies for visceral artery aneurysms


Chirurgia ◽  
2020 ◽  
Vol 33 (1) ◽  
Author(s):  
Baker M. Ghoniem ◽  
Ahmed A. Shaker ◽  
Mahmoud Nasser ◽  
Amr Gad

2017 ◽  
Vol 10 ◽  
pp. 117955221771143 ◽  
Author(s):  
Catherine Linzay ◽  
Abhishek Seth ◽  
Kunal Suryawala ◽  
Ankur Sheth ◽  
Moheb Boktor ◽  
...  

Background: Hepatic artery aneurysms (HAAs) constitute 14% to 20% of visceral artery aneurysms. Most HAAs are asymptomatic. Although rare, obstructive jaundice due to external bile duct compression or rupture of the HAA into the biliary tree with occlusion of the lumen from blood clots has been reported. Case presentation: A 56-year-old white man presented to an outside hospital with symptoms of obstructive jaundice, including abdominal pain and yellowing of the skin. Imaging showed a large HAA. Patient was transferred to our hospital where an endoscopic retrograde cholangiopancreatography with biliary stenting was performed. This was followed by coil embolization of the HAA with improvement in symptoms and liver chemistries. Conclusions: Most clinicians agree that management of HAA is highly variable and depends on clinical presentation and anatomic location. Biliary stenting provides temporary relief for patients with obstructive jaundice. Definitive options include open aneurysmal repair versus endovascular therapy. Hepatic artery aneurysms represent a significant risk for hemorrhage and therefore must be addressed promptly once discovered.


2010 ◽  
Vol 51 (4) ◽  
pp. 1071
Author(s):  
Grant T. Fankhauser ◽  
William M. Stone ◽  
Sailendra G. Naidu ◽  
Gustavo S. Oderich ◽  
Joseph J. Ricotta ◽  
...  

1977 ◽  
Vol 133 (5) ◽  
pp. 636-639 ◽  
Author(s):  
Cornelius Olcott ◽  
William K. Ehrenfeld

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