Visceral Artery Aneurysms

2015 ◽  
Author(s):  
Louise A. Corle ◽  
Erica L. Mitchell
Keyword(s):  
Early Recognition ◽  
Imaging Techniques ◽  
Celiac Artery ◽  
Liver Trauma ◽  
Preoperative Imaging ◽  
Visceral Artery ◽  
Management Options ◽  
Visceral Artery Aneurysms ◽  
Arterial Trauma ◽  
Splanchnic Artery

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.

scholarly journals Current management strategies for visceral artery aneurysms: an overview

Surgery Today ◽  
2019 ◽  
Vol 50 (1) ◽  
pp. 38-49 ◽  
Author(s):  
Hideaki Obara ◽  
Matsubara Kentaro ◽  
Masanori Inoue ◽  
Yuko Kitagawa
Keyword(s):  
Mesenteric Artery ◽  
Management Strategies ◽  
Hybrid Approach ◽  
Celiac Artery ◽  
Visceral Artery ◽  
Anatomical Location ◽  
Current Management ◽  
Risk Of Rupture ◽  
Visceral Artery Aneurysms ◽  
History Of

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.

scholarly journals Visceral Artery Aneurysms: Decision Making and Treatment Options in the New Era of Minimally Invasive and Endovascular Surgery

2019 ◽  
Vol 28 (01) ◽  
pp. 011-016 ◽  
Author(s):  
Jun Xu ◽  
Mel Sharafuddin ◽  
John Corson ◽  
Maen Hosn
Keyword(s):  
Mesenteric Artery ◽  
Incidental Finding ◽  
Treatment Options ◽  
Current Treatment ◽  
Celiac Artery ◽  
Visceral Artery ◽  
Management Guidelines ◽  
New Era ◽  
Visceral Artery Aneurysms ◽  
Arterial Aneurysms

AbstractThe abdominal viscera blood supply is derived from anterior branches of the abdominal aorta. Visceral artery aneurysms (VAAs) include aneurysms of the following arteries and their branches: the celiac artery, the hepatic artery, the splenic artery, the superior mesenteric artery, the inferior mesenteric artery, the pancreaticoduodenal artery, and the gastroduodenal artery. Overall VAAs comprise < 2% of all types of arterial aneurysms. Asymptomatic VAAs are now being encountered more frequently due to the widespread use of advanced diagnostic abdominal imaging. The incidental finding of a VAA frequently leaves clinicians with a dilemma as to the best course of management. The focus of this review is on current treatment options and management guidelines for both symptomatic and asymptomatic VAAs.

Descending Thoracic and Thoracoabdominal Aortic Aneurysms: Open and Endovascular Repair

2013 ◽  
Author(s):  
Naveed U. Saqib ◽  
Robert Y. Rhee
Keyword(s):  
Imaging Techniques ◽  
Artery Bypass ◽  
Preoperative Evaluation ◽  
Aortic Aneurysms ◽  
Visceral Artery ◽  
Thoracoabdominal Aneurysm ◽  
Management Options ◽  
Thoracic Aortic Aneurysms ◽  
Fenestrated Endograft

The prevalence of descending thoracic aortic aneurysms (DTAs) and thoracoabdominal aortic aneurysms (TAAAs) are described. Imaging techniques and classification is given. Preoperative evaluation is described in detail, as prior to proceeding with repair of a DTA or a TAAA, patients must be thoroughly evaluated medically to determine if they are physiologically fit enough for repair. Indications for repair, primarily relating to size of aneurysm, are listed for both DTAs and TAAAs. Repair options and management for DTAs now includes thoracic endovascular aortic repair (TEVAR); its outcomes, benefits, and drawbacks are discussed in detail. The discussion of TAAAs is similar, with indications for repair and surgical management options given: direct open repair; a debranching procedure with subsequent endograft repair; and branched or fenestrated endograft repair. A table lists the symptoms attributable to thoracic and thoracoabdominal aortic aneurysms. Figures show the classification of DTAs; the evaluation of a patient with a thoracic aortic aneurysm; available thoracic endografts; anatomic restrictions for TEVAR; evaluation of a patient with a thoracoabdominal aneurysm; regional spinal cord hypothermic protection; distal aortic perfusion; visceral artery bypass; and a branched endograft.  This review contains 8 figures, 3 tables, and 125 references.

scholarly journals Spontaneous haemorrhage from a left gastric artery aneurysm as a cause of acute abdominal pain

2017 ◽  
Vol 99 (2) ◽  
pp. e49-e51 ◽  
Author(s):  
CR Gregory ◽  
VK Proctor ◽  
SM Thomas ◽  
K Ravi
Keyword(s):  
Acute Abdominal Pain ◽  
Early Recognition ◽  
Artery Aneurysm ◽  
Left Gastric Artery ◽  
Visceral Artery ◽  
Gastric Artery ◽  
Risk Of Rupture ◽  
Visceral Artery Aneurysms ◽  
Impact On Survival ◽  
Spontaneous Haemorrhage

Visceral artery aneurysms are rare, with a reported incidence of less than 2% in the general population. 1,2 Aneurysms of the left gastric artery are particularly uncommon, accounting for 4% of all visceral aneurysms. 3,4 Although the majority are discovered incidentally and can be managed conservatively, prompt treatment of those ruptured or at risk of rupture is crucial to reduce the associated morbidity. Increasing awareness of visceral artery aneurysms as a cause of spontaneous intraperitoneal haemorrhage will improve early recognition and impact on survival. We present a rare case of spontaneous rupture of a left gastric artery aneurysm.

Concurrent Treatment of Acute Pancreatitis and Multiple Visceral Artery Aneurysms Using Endovascular Techniques

2012 ◽  
Vol 46 (3) ◽  
pp. 283-286 ◽  
Author(s):  
Mario Mitkov ◽  
Weesam Kassim Al-Khatib ◽  
Wei Zhou
Keyword(s):  
Acute Pancreatitis ◽  
Surgical Techniques ◽  
Artery Aneurysm ◽  
Celiac Artery ◽  
Gastroduodenal Artery ◽  
Visceral Artery ◽  
Endovascular Techniques ◽  
Concurrent Treatment ◽  
Visceral Artery Aneurysms ◽  
Celiac Artery Aneurysm

Multiple aneurysms involving the celiac axis are extremely rare. Celiac artery aneurysms account for only 4% of all visceral aneurysms with 40% having concomitant aneurysms such as gastroduodenal artery (GDA) aneurysms. Development of a GDA aneurysm is associated with pancreatitis. If a GDA aneurysm ruptures, traditional repair is through open surgical techniques with significant morbidity and mortality as up to 50% occur in the setting of chronic pancreatitis. However, a ruptured GDA aneurysm causing pancreatitis has not been described previously. We report a case of successful endovascular treatment of a ruptured GDA aneurysm and concomitant celiac artery aneurysm leading to the resolution of acute pancreatitis.

scholarly journals Endovascular treatment of wide-neck saccular renal artery aneurysm with waffle-cone technique

2021 ◽  
Vol 20 ◽  
Author(s):  
Paulo Eduardo Ocke Reis ◽  
Guilherme de Palma Abrão ◽  
Leonardo Roever
Keyword(s):  
Endovascular Procedures ◽  
Imaging Techniques ◽  
Artery Aneurysm ◽  
Visceral Artery ◽  
Endovascular Management ◽  
Endovascular Techniques ◽  
The Past ◽  
Visceral Artery Aneurysms ◽  
History Of ◽  
Wide Neck

Abstract In the past, treatment of visceral artery aneurysms (VAAs) was exclusively surgical. These aneurysms were rarely diagnosed in elective or emergency cases. Development of imaging techniques and endovascular procedures has changed the history of the therapeutic options for this pathology. Endovascular management of VAAs has arisen to advances in endovascular techniques and has achieved high efficacy.

scholarly journals Celiacomesenteric trunk associated with superior mesenteric artery aneurysm: A case report and review of literature

2020 ◽  
Vol 8 ◽  
pp. 2050313X2093824
Author(s):  
Walid Alam ◽  
Mohammed Hussein Kamareddine ◽  
Amine Geahchan ◽  
Youssef Ghosn ◽  
Michel Feghaly ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Incidental Finding ◽  
Imaging Techniques ◽  
Artery Aneurysm ◽  
Celiac Trunk ◽  
Visceral Artery ◽  
Diffuse Abdominal Pain ◽  
Visceral Artery Aneurysms ◽  
Celiacomesenteric Trunk

In rare cases, the celiac artery and the superior mesenteric artery arise from a common origin known as a common celiacomesenteric trunk. Celiac trunk stenosis or occlusion has been reported to accompany this anatomical aberrancy. Even rarer, are aneurysms associated with this common celiacomesenteric trunk. In general, visceral artery aneurysms are uncommon. We hereby present a 39-year-old female patient with a 1-month history of mild diffuse abdominal pain, with an incidental finding of superior mesenteric artery aneurysm on abdominal ultrasound. Subsequent contrast-enhanced computed tomography revealed severe narrowing of the celiac trunk and saccular aneurysmal dilatation of the superior mesenteric artery. Coil embolization of the aneurysm was performed, while maintaining persistent flow in the superior mesenteric artery and celiacomesenteric trunk. Visceral artery aneurysms are increasingly being identified incidentally with improvement in imaging techniques. The question lies whether to treat these aneurysms or observe. No universal guidelines exist regarding that matter, but the decision to intervene is made based on aneurysm location, size, and patient characteristics.

scholarly journals Renal Autotransplant and Celiac Artery Bypass for Aneurysmal Degeneration Related to Neurofibromatosis Type 1

2019 ◽  
Vol 53 (6) ◽  
pp. 497-500
Author(s):  
Natalie A. Drucker ◽  
Maher F. Blaibel ◽  
Santosh Nagaraju ◽  
S. Keisin Wang ◽  
William Goggins ◽  
...  
Keyword(s):  
Neurofibromatosis Type 1 ◽  
Artery Bypass ◽  
Neurofibromatosis Type ◽  
Celiac Artery ◽  
Visceral Artery ◽  
Chronic Mesenteric Ischemia ◽  
Artery Pseudoaneurysm ◽  
Visceral Artery Aneurysms ◽  
Renal Autotransplantation

We present a case of an 18-year-old female with neurofibromatosis type 1 who presented with abdominal pain and weight loss secondary to chronic mesenteric ischemia due to celiac axis occlusion and was subsequently found to have multiple visceral artery aneurysms. Of clinical significance, 2 aneurysms of the right renal artery were noted at the hilum, with the larger one having a diameter of 2.4 cm. After initial endovascular treatment with stenting of a concurrent pancreaticoduodenal artery pseudoaneurysm, staged aorto-hepatic bypass and right nephrectomy with renal autotransplantation after back table resection of the aneurysmal segments were successfully completed.

Diagnostic workup and endovascular treatment of popliteal artery trauma

VASA ◽  
2019 ◽  
Vol 48 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Cheong J. Lee ◽  
Rory Loo ◽  
Max V. Wohlauer ◽  
Parag J. Patel
Keyword(s):  
Vascular Injury ◽  
Gold Standard ◽  
Imaging Techniques ◽  
Computed Tomographic Angiography ◽  
Vascular Trauma ◽  
Endovascular Techniques ◽  
Computed Tomographic ◽  
Arterial Injuries ◽  
Arterial Trauma ◽  
Peripheral Arterial

Abstract. Although management paradigms for certain arterial trauma, such as aortic injuries, have moved towards an endovascular approach, the application of endovascular techniques for the treatment of peripheral arterial injuries continues to be debated. In the realm of peripheral vascular trauma, popliteal arterial injuries remain a devastating condition with significant rates of limb loss. Expedient management is essential and surgical revascularization has been the gold standard. Initial clinical assessment of vascular injury is aided by readily available imaging techniques such as duplex ultrasonography and high resolution computed tomographic angiography. Conventional catheter based angiography, however, remain the gold standard in the determination of vascular injury. There are limited data examining the outcomes of endovascular techniques to address popliteal arterial injuries. In this review, we examine the imaging modalities and current approaches and data regarding endovascular techniques for the management popliteal arterial trauma.

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