Visceral Artery Aneurysms: A 40-Year Experience from a Single Center

Ariana Marie Martin; Mauricio Gonzalez-Urquijo; Jose Francisco Vargas; Leopoldo Marine; Michel Bergoeing; Renato Mertens; Francisco Valdes

doi:10.1016/j.avsg.2024.12.042

Visceral Artery Aneurysms: A 40-Year Experience from a Single Center

Ann Vasc Surg. 2024 Dec 27:S0890-5096(24)00862-8. doi: 10.1016/j.avsg.2024.12.042. Online ahead of print.

Authors

Ariana Marie Martin¹, Mauricio Gonzalez-Urquijo¹, Jose Francisco Vargas¹, Leopoldo Marine¹, Michel Bergoeing¹, Renato Mertens¹, Francisco Valdes²

Affiliations

¹ Departamento de Cirugía Vascular y Endovascular, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
² Departamento de Cirugía Vascular y Endovascular, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. Electronic address: pancho.valdes.e@gmail.com.

PMID: 39733998
DOI: 10.1016/j.avsg.2024.12.042

Abstract

Background: Visceral artery aneurysms (VAAs) are a relatively uncommon phenomenon, occurring all types of VAA at an incidence of 0.01% to 0.2%. The present study aims to describe the clinical characteristics, and treatment outcomes of patients with VAAs treated at a Chilean academic institution over the past 40 years.

Methods: Single center retrospective study of patients with VAAs surgically treated between August 1982 and May 2023. Data encompassing patient demographics, aneurysm characteristics, treatment modalities, and outcomes were analyzed.

Results: The cohort included 59 patients with 64 aneurysms, predominantly female (n=35, 59.3%) with a median age of 51 years (range: 21-86 years). The most common VAAs were localized in the renal (n=32, 50.0%) and splenic arteries (n=20, 31.3%). Endovascular procedures were performed in 27 (42.2%) cases, and open surgery in 37 (57.8%) cases. Two (3.1%) cases were treated with renal autotransplantation, aneurysmectomy was performed in three (4.7%) cases, prosthetic bypass in 10 cases (15.6%), and vein bypass in 22 cases (34.4%). Embolization was employed in 21 cases (32.8%), covered stenting in 5 cases (7.8%), and one case (1.6%) received both embolization and stenting. Technical success was 100% in the endovascular group vs. 97.0% in the open group (p=0.387). Overall, the complication rate was 6.7% (n=4) with a 30-day mortality rate of 2.1% (n=1). Median follow-up was 60.5 months (6-318 months), with a long-term mortality rate of 5.0% (n=3). Patients operated on during the first time frame era, before the endovascular era, (1982-2002) had larger aneurysms than those operated on in the second time frame (2003-2023), with a median size of 30 mm versus 23 mm, respectively (p < 0.04).

Conclusions: In the present study, both open repair and endovascular repair had similar surgical outcomes; however, the shift seen over time towards endovascular interventions aligns with current trends favoring less invasive procedures.

Keywords: endovascular repair; open surgical repair; renal artery aneurysm; splenic artery aneurysm; visceral artery aneurysm.