Endovascular Treatment of Visceral Artery Aneurysms and Pseudoaneurysms With Stent-Graft: Analysis of Immediate and Long-Term Results

Background: With estimated prevalence of 1% of the general population, visceral artery aneurysms are not a frequent pathology, however, their rupture is a life-threatening occurrence with mortality rate ranging from 10% to 25%, up to 75% in case of pregnant women. Therefore, the identification and treatment of visceral artery aneurysms is of great importance in the prevention of early rupture. Purpose: To assess the effectiveness and safety of treatment of visceral artery aneurysms with various endovascular methods focusing on technical aspects, complications and long-term clinical outcome. Materials and Methods: 60 patients with visceral artery aneurysms were treated percutaneously. Various techniques were used: coiling (23), covered stents (15), thrombin (7), and other mixed techniques. Aneurysm characteristics, size and localization, procedural data, peri-procedural complications, technical success, 90- and 180-day clinical success and follow-up period (aneurysm exclusion, patency of the artery and complications) were prospectively analyzed. Results: Te procedure was performed in 57 of 60 patients. In 56 of 57 patients aneurysms ware effectively excluded. Te success rate was 93.3% (56 of 60 enrolled patients). Technical success after the intervention was 82.4%, after second 98.2%. Embolization with covered stents ware characterized by highest efficiency. Serious complications occurred in 1.8% of cases. Conclusions. The minimally invasive endovascular treatment of visceral artery aneurysms is characterized by high efficacy and safety. Good treatment results depend on proper assessment of the aneurysm’s morphology as well as on selection of the appropriate vascular approach and endovascular technique.

Download Full-text

The Evaluation of Aortic Diameter Changes During Long-Term Follow-Up After Endovascular Treatment of Acute Blunt Traumatic Thoracic Aortic Injuries

Vascular and Endovascular Surgery ◽

10.1177/1538574418765385 ◽

2018 ◽

Vol 52 (5) ◽

pp. 335-343 ◽

Cited By ~ 6

Author(s):

Federico Fontana ◽

Edoardo Macchi ◽

Filippo Piacentino ◽

Larissa Nocchi Cardim ◽

Giuseppe De Marchi ◽

...

Keyword(s):

Endovascular Treatment ◽

Stent Graft ◽

Mean Value ◽

Aortic Diameter ◽

Long Term Results ◽

Technical Success ◽

Long Term Follow Up ◽

Aortic Injuries

Purpose: To evaluate the variations in aortic diameters and long-term results in patients who underwent thoracic endovascular aortic repair (TEVAR) for acute blunt traumatic thoracic aortic injuries (BTTAIs). Materials and Methods: We retrospectively evaluated 23 patients with a mean age of 39 years (range: 17-74 years) who underwent TEVAR for BTTAI between October 2000 and November 2014. All of the patients underwent computed tomography angiography (CTA) before hospital discharge as a baseline imaging for the subsequent follow-up examinations. The technical success, overall survival, and complications were evaluated. Furthermore, the aortic diameters outside of the stent-graft (1 cm proximal and 1 cm distal to the stent-graft) and the aortic diameters within the stent-graft (2 cm distal to the proximal end and 2 cm proximal to the distal end) were assessed. The diameters at baseline on CTA were compared with those of the latest available follow-up examination. Results: Technical success was 100% with a mean follow-up of 65.4 months (range: 12-171 months). No death was registered, and 2 (8.7%) of 23 endograft-related complications (1 stent-graft distal infolding and 1 endoleak 2 and 4 months after the procedure, respectively) were observed. An increase in aortic diameter either proximal or distal to the stent-graft (mean value 0.7 and 0.5 mm, respectively) or within the stent-graft (mean value of 0.5 mm for both proximal and distal diameters) was registered (mean follow-up at 65.4 months, range: 12-171 months). Conclusion: Aortic dilatation following TEVAR for BTTAI is minimal during long-term follow-up. Endovascular treatment represents a durable and safe option in acute BTTAIs.

Download Full-text

Endovascular Treatment of Visceral Artery Aneurysms

Journal of Endovascular Therapy ◽

10.1177/152660280200900108 ◽

2002 ◽

Vol 9 (1) ◽

pp. 38-47 ◽

Cited By ~ 74

Author(s):

Andreas Gabelmann ◽

Johannes Görich ◽

Elmar M. Merkle

Keyword(s):

Endovascular Treatment ◽

Necrotizing Pancreatitis ◽

Artery Aneurysm ◽

Endovascular Embolization ◽

Visceral Artery ◽

Recurrent Bleeding ◽

Visceral Artery Aneurysms ◽

Long Term Follow Up ◽

Transcatheter Coil Embolization

Purpose: To review a 10-year experience with endovascular embolization of visceral artery aneurysms. Methods: Twenty-five patients (13 men; mean age 52.1 years, range 31–80) presented with VAAs of varying locations and etiologies: 10 splenic, 3 gastroduodenal, 2 pancreaticoduodenal, 3 hepatic, 3 superior mesenteric, 2 celiac, 1 left gastric, and 1 jejunoileal. Ten patients were asymptomatic; 7 aneurysms were ruptured. Transcatheter coil embolization was the treatment of choice in all patients. Results: Coil placement was initially (<7 days) successful in 23 (92%) patients. One superior mesenteric artery aneurysm remained perfused, and recurrent bleeding occurred 2 days after intervention in 1 case, but repeated embolization excluded the aneurysm. One patient with necrotizing pancreatitis died from sepsis 10 days after endovascular treatment and surgery (4% 30-day mortality). Long-term follow-up revealed excellent results after an average 48.7 months (range 14–75) with only 1 recurrence after 12 months. Conclusions: Embolotherapy is the treatment of choice in visceral artery aneurysms, regardless of etiology, location, or clinical presentation.

Download Full-text

Long-term Results of Endovascular Treatment of TASC C and D Aortoiliac Occlusive Disease with Expanded Polytetrafluoroethylene Stent Graft

Annals of Vascular Surgery ◽

10.1016/j.avsg.2018.07.060 ◽

2019 ◽

Vol 56 ◽

pp. 254-260 ◽

Cited By ~ 9

Author(s):

Umberto Marcello Bracale ◽

Anna Maria Giribono ◽

Domenico Spinelli ◽

Luca Del Guercio ◽

Narayana Pipitò ◽

...

Keyword(s):

Endovascular Treatment ◽

Stent Graft ◽

Occlusive Disease ◽

Long Term Results ◽

Aortoiliac Occlusive Disease ◽

Expanded Polytetrafluoroethylene

Download Full-text

Endovascular Treatment of Giant Splenic Artery Aneurysm

Case Reports in Surgery ◽

10.1155/2012/964093 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Adenauer Marinho de Oliveira Góes Junior ◽

Amanda Silva de Oliveira Góes ◽

Paloma Cals de Albuquerque ◽

Renato Menezes Palácios ◽

Simone de Campos Vieira Abib

Keyword(s):

Endovascular Treatment ◽

Stent Graft ◽

Splenic Artery ◽

Artery Aneurysm ◽

Giant Aneurysm ◽

Visceral Artery ◽

Aggressive Approach ◽

Visceral Artery Aneurysms ◽

Stent Graft Implantation ◽

Graft Implantation

Introduction. Visceral artery aneurysms are uncommon. Among them, splenic artery is the most common (46–60%). Most splenic artery aneurysms are asymptomatic and diagnosed incidentally, but its rupture, potentially fatal, occurs in up to 8% of cases.Presentation of Case. A female patient, 64 years old, diagnosed with a giant aneurysm of the splenic artery (approximately 6.5 cm in diameter) was successfully submitted to endovascular treatment by stent graft implantation.Discussion. Symptomatic aneurysms and those larger than 2 cm represent some of the main indications for intervention. The treatment may be by laparotomy, laparoscopy, or endovascular techniques. Among the various endovascular methods discussed in this paper, there is stent graft implantation, a method still few reported in the literature.Conclusion. Although some authors still consider the endovascular approach as an exception to the treatment of SAA, in major specialized centers these techniques have been consolidated as the preferred choice, reserving the surgical approach in cases where this cannot be used. For being a less aggressive approach, it offers an opportunity of treatment to patients considered “high risk” for surgical treatment by laparotomy/laparoscopy.

Download Full-text