Endovascular treatment of visceral and renal artery aneurysms

Abstract

Purpose: To analyze early and midterm results of endovascular treatment of visceral aneurysms regarding technical considerations, technical success rate, aneurysm rupture, and end-organ ischemia.

Materials and methods: Endovascular treatment of 41 visceral and renal artery aneurysms (VAAs) in 40 consecutive patients (25 women; mean age, 59.4 y ± 16.2) was retrospectively reviewed. The series included 30 true aneurysms and 11 pseudoaneurysms in renal (n = 17), splenic (n = 13), hepatic (n = 4), celiac (n = 4), gastroduodenal (n = 2), and middle colic (n = 1) arteries. Demographic, clinical, procedural, and follow-up data were analyzed.

Results: Forty-one aneurysms underwent endovascular treatment. Hypertension (73%) and hyperlipidemia (32%) were the most common associated comorbidities. Nineteen patients presented with symptoms of pain (15%) or rupture (32%) in 10 pseudoaneurysms (91%) and nine true aneurysms (30%; P = .0007). The most commonly used technique (93%) was coil embolization with (15%) or without (78%) other endovascular agents. The rate of technical success (cessation of hemorrhage or blood flow into aneurysm sac) was 98%. There was no periprocedural mortality. Mean hospital stays were 1 and 2 days for asymptomatic and symptomatic patients, respectively. Mean clinical follow-up was 44.5 months; mean imaging follow-up was 11.7 months. The only complication was an intraprocedural thromboembolic event in one case (3%). Follow-up imaging evidence of end-organ partial infarct was detected in six patients (21%), with no clinical evidence of organ insufficiency.

Conclusions: Endovascular treatment of VAAs is a safe and highly successful procedure. Associated side effects such as distal embolization and end-organ infarcts were not found to be clinically significant.