[Problems of indications for the treatment of aneurysm of the visceral arteries]

Abstract

The authors report the clinical history and the treatment of 5 patients with visceral artery aneurysms. The celiac trunk, the common hepatic artery, the inferior pancreaticoduodenal artery and the splenic artery (in 2 different patients) were affected by the aneurysmal disease. Various techniques have been employed in the successful treatment of these patients: radiological embolization of the celiac trunk aneurysms, Dacron graft reconstruction of the common hepatic artery aneurysm, endosaccular ligature and PTFE patching of the inferior pancreatico-duodenal artery aneurysm, endosaccular ligature in one of the two splenic artery aneurysm and simple ligature and splenectomy in the remainder splenic artery aneurysm. Early diagnosis is important in these lesions, because of the trend toward rupture and subsequent high mortality rate. Ultrasonography (US), Computed Tomography (CT) and Magnetic Resonance (MR) are very helpful as diagnostic tools, however angiography represents the method of choice since it could be the first step of the embolization treatment. Furthermore angiography is useful for detection of associated visceral lesions and for the study of collateral blood supply. Treatment choice depends on visceral artery aneurysms localization, the presence of associate lesions and the possible general contraindications. In the latter case, radiological embolization could be the first-choice treatment.