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Visceral Artery Aneurysms

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Textbook of Emergency General Surgery

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Abstract

Visceral artery aneurysms (VAAs) affect the vessels of the splanchnic arterial circulation, including the celiac axis, the superior and inferior mesenteric arteries, and their tributaries. VAAs present a diagnostic challenge because of their insidious nature; most VAAs are asymptomatic until rupture, which carries a mortality of 25%. Furthermore, the natural history of VAAs and the factors that predispose rupture are not well understood on account of their scarcity.

VAAs are usually diagnosed incidentally on imaging obtained for other reasons. Most are slow-growing. Smaller aneurysms are amenable to long-term surveillance depending on the location and characteristics of the aneurysm as well as the overall condition of the patient. In a subset of cases, though, repair is indicated regardless of size.

Surgery for VAAs employs both open and endovascular techniques for elective repair as well as for ruptured aneurysms. Here, we review the indications for repair for each subtype of aneurysm by location, as well as considerations for the selection of an operative strategy. These life-threatening entities warrant an aggressive approach to diagnosis and treatment.

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Further Reading

  • Abbas MA, Stone WM, Fowl RJ, Gloviczki P, Oldenburg WA, Pairolero PC, et al. Splenic artery aneurysms: two decades experience at Mayo Clinic. Ann Vasc Surg. 2002;16(4):442–9.

    Article  PubMed  Google Scholar 

  • Barrionuevo P, Malas MB, Nejim B, Haddad A, Morrow A, Ponce O, et al. A systematic review and meta-analysis of the management of visceral artery aneurysms. J Vasc Surg. 2020;72(1):40S–5S.

    Article  PubMed  Google Scholar 

  • Chaer RA, Abularrage CJ, Coleman DM, Eslami MH, Kashyap VS, Rockman C, et al. The Society for Vascular Surgery clinical practice guidelines on the management of visceral aneurysms. J Vasc Surg. 2020;72(1):3S–39S.

    Article  PubMed  Google Scholar 

  • Corey MR, Ergul EA, Cambria RP, English SJ, Patel VI, Lancaster RT, et al. The natural history of splanchnic artery aneurysms and outcomes after operative intervention. J Vasc Surg. 2016;63(4):949–57.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Jonathan Parks & George C. Velmahos

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  1. Jonathan Parks
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  2. George C. Velmahos
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Correspondence to Jonathan Parks .

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Editors and Affiliations

  1. General, Emergency and Trauma Surgery Dept., Pisa University Hospital, Pisa, Italy

    Federico Coccolini

  2. General and Emergency Surgery Dept., Bufalini Hospital, Cesena, Italy

    Fausto Catena

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Parks, J., Velmahos, G.C. (2023). Visceral Artery Aneurysms. In: Coccolini, F., Catena, F. (eds) Textbook of Emergency General Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-22599-4_104

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  • DOI: https://doi.org/10.1007/978-3-031-22599-4_104

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