Visceral Artery Aneurysms: Diagnosis, Surveillance, and Treatment
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Visceral artery aneurysms (VAAs) are a rare, but serious clinical entity as rupture confers a high rate of mortality. Data regarding the prevalence, treatment, and prognosis of VAAs is largely from case series, as true randomized trials are lacking. The incidence of VAAs has risen over the decades with advances in imaging technology, availability, and utilization. Even in the presence of symptoms, the prompt diagnosis of VAAs may be challenging as symptoms are often nonspecific and varied. Although there are no definitive treatment guidelines, asymptomatic VAAs require treatment in the following scenarios: when the aneurysm diameter is greater than 2 cm, when identified during pregnancy, when multiple aneurysms are present, and in the case of hepatic transplant. Similar to therapeutic trends in other vascular beds, advances in endovascular devices and techniques have driven an “endovascular first” approach for the treatment of VAAs. However, although the success rates of endovascular repair are impressive, surgical intervention is still necessary in treating centers. This paper reviews the pathophysiology, clinical features, anatomic characteristics, and management strategies required for the effective diagnosis and treatment of VAAs.
KeywordsVisceral artery aneurysms VAAs Endovascular repair Vascular disease
Compliance with Ethical Standards
Conflict of Interest
Fady Ibrahim, Jonathan Dunn, John Pellerito, and Andrew Galmer each declare no potential conflicts of interest.
John Rundback reports personal fees from Bayer, Daiichi Sanko, Philips, Toray & Vesper, personal fees from Abbott, Boston Scientific, Medtronic, personal fees from EXIMO, personal fees from VIVA PHYSICIANS, personal fees from ABBOTT, COOK, CSI, GORE, MEDTRONIC, non-financial support from Medtronic, NIH, Biologic, Cordis, PQ Bypass, Limflo, Mercator, Surmodics, Intact Vascular, non-financial support from EKOS, other from EXIMO.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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