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Endovascular Treatment of Visceral Aneurysms and Pseudoaneurysms: Long-term Outcomes from a Multicenter European Study

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Abstract

Purpose

To investigate the percutaneous endovascular management of visceral aneurysms (VA) and visceral pseudoaneurysms (VPA) treated in three European interventional radiology departments.

Methods

Patient archives from the department’s databases were examined and retrospectively analyzed. Patients diagnosed between 2000 and 2010 with VA and/or VPA, confirmed by computed tomography angiography, magnetic resonance angiography, or digital subtraction angiography and treated exclusively with percutaneous endovascular methods, were included in the study. The study’s primary end points were procedural technical success, target lesion reintervention rate, and periprocedural mortality rate. Secondary end points included major and minor complications rates.

Results

The medical records of 54 patients (41 male, mean age 55 ± 18.1 years) with 58 VAs or VPAs and treated with various percutaneous endovascular therapeutic modalities were analyzed. In total, 21 VAs (mean diameter 49.4 ± 21 mm, range 20–100 mm) and 37 VPAs (mean diameter 25.1 ± 14.6 mm, range 8–60 mm) were treated. Procedural technical success was achieved in 100% of the cases, while target lesion reintervention rate was 6.1% (2 of 33) and 14.2% (3 of 21) in the VPA and VA groups, respectively. Mean clinical follow-up period was 19.1 ± 21.4 months. Overall periprocedural mortality rate was 3% (1 of 33) in the VPA group and 0% (0 of 21) in the VA group.

Conclusion

Percutaneous endovascular treatment of VAs and VPAs is safe and effective with low morbidity and mortality. There is a small but significant reintervention rate, particularly for true aneurysms; dedicated follow-up imaging is recommended. Successful aneurysm exclusion was achieved in all cases with a second procedure.

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References

  1. Hossain A, Reis ED, Dave SP et al (2001) Visceral artery aneurysms: experience in a tertiary-care center. Am Surg 67:432–437

    PubMed  CAS  Google Scholar 

  2. Bedford PD, Lodge B (1960) Aneurysm of the splenic artery. Gut 1:312–320

    Article  PubMed  CAS  Google Scholar 

  3. Lauschke H, Rudolph J, Textor J et al (2002) Das Visceralarterienaneurysma. Zentralbl Chir 127:538–542

    Article  PubMed  CAS  Google Scholar 

  4. Tulsyan N, Kashyap VS, Greenberg RK et al (2007) The endovascular management of visceral artery aneurysms and pseudoaneurysms. J Vasc Surg 45:276–283

    Article  PubMed  Google Scholar 

  5. Sachdev-Ost Ulka (2010) Visceral artery aneurysms: review of current management options. Mt Sinai J Med 77:296–303

    Article  PubMed  Google Scholar 

  6. Hirsch AT, Haskal ZJ, Herztner NR et al (2006) ACC/AHA 2005 guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric and aortic). G Am Coll Cardiol 47:1239–1312

    Article  Google Scholar 

  7. Leoni CJ, Potter JE, Rosen MP et al (2001) Classifying complications of interventional procedures: a survey of practicing radiologists. J Vasc Interv Radiol 12:55–59

    Article  PubMed  CAS  Google Scholar 

  8. Carr SC, Pearce WH, Vogelzang RL et al (1996) Current management of visceral artery aneurysms. Surgery 120:627–633

    Article  PubMed  CAS  Google Scholar 

  9. Shanley CJ, Shah NL, Messina LM (1996) Common splanchnic artery aneurysms: splenic, hepatic, and celiac. Ann Vasc Surg 10:315–322

    Article  PubMed  CAS  Google Scholar 

  10. Gabelmann A, Görich J, Merkle EM (2002) Endovascular treatment of visceral artery aneurysms. J Endovasc Ther 9:38–47

    Article  PubMed  Google Scholar 

  11. Stanley JC, Wakefield TW, Graham LM et al (1986) Clinical importance and management of splanchnic artery aneurysms. J Vasc Surg 3:836–840

    PubMed  CAS  Google Scholar 

  12. Pasha SF, Glolviczki P, Stanson AW, Kamath PS (2007) Splanchnic artery aneurysms. Mayo Clin Proc 82:472–479

    Article  PubMed  Google Scholar 

  13. Arca MJ, Gagner M, Heniford BT et al (1999) Spenic artery aneurysms: methods of laparoscopic repair. J Vasc Surg 30:184–188

    Article  PubMed  CAS  Google Scholar 

  14. Laganà D, Carrafiello G, Mangini M et al (2006) Multimodal approach to endovascular treatment of visceral artery aneurysms and pseudoaneurysms. Eur J Radiol 59:104–111

    Article  PubMed  Google Scholar 

  15. Pulli R, Dorigo W, Troisi N et al (2008) Surgical treatment of visceral artery aneurysms: a 25-year experience. J Vasc Surg 48:334–342

    Article  PubMed  Google Scholar 

  16. Mauro MA, Jacques P (1991) Transcatheter management of pseudoaneurysms complicating pancreatitis. J Vasc Interv Radiol 2:527–532

    Article  PubMed  CAS  Google Scholar 

  17. Marone EM, Mascia D, Kahlberg A et al (2011) Is open repair still the gold standard in visceral artery aneurysm management? Ann Vasc Surg 25:936–946

    Article  PubMed  Google Scholar 

  18. Ikeda O, Nakasone Y, Tamura Y, Yamashita Y (2010) Endovascular management of visceral artery pseudoaneurysms: transcatheter coil embolization using the isolation technique. Cardiovasc Intervent Radiol 33:1128–1134

    Article  PubMed  Google Scholar 

  19. Cochennec F, Riga CV, Allaire E et al (2011) Contemporary management of splanchnic and renal artery aneurysms: results of endovascular compared with open surgery from two European vascular centers. Eur J Vasc Endovasc Surg 42(3):340–346

    Article  PubMed  CAS  Google Scholar 

  20. Gabelmann A, Gorich J, Merkle EM (2002) Endovascular treatment of visceral artery aneurysms. J Endovasc Ther 9:38–47

    Article  PubMed  Google Scholar 

  21. Tessier DJ, Stone WM, Fowl RJ et al (2003) Clinical features and management of splenic artery pseudoaneurysm: case series and cumulative review of literature. J Vasc Surg 38:969–974

    Article  PubMed  Google Scholar 

  22. Carmo M, Mercandalli G, Rampoldi A et al (2008) Transcatheter thrombin embolization of a giant visceral artery aneurysm. J Cardiovasc Surg (Torino) 49:777–782

    CAS  Google Scholar 

  23. Lameris R, du Plessis J, Nieuwoudt M et al (2011) A visceral pseudoaneurysm: management by EUS-guided thrombin injection. Gastrointest Endosc 73:392–395

    Article  PubMed  Google Scholar 

  24. Bratby MJ, Lehmann ED, Bottomley J et al (2006) Endovascular embolization of visceral artery aneurysms with ethylene-vinyl alcohol (Onyx): a case series. Cardiovasc Intervent Radiol 29:1125–1128

    Article  PubMed  CAS  Google Scholar 

  25. Kawai N, Sato M, Tanihata H et al (2010) Repair of traumatic abdominal aortic pseudoaneurysm using N-butyl-2-cyano-acrylate embolization. Cardiovasc Intervent Radiol 33:406–409

    Article  PubMed  Google Scholar 

  26. Graham LM, Rubin JR (1994) Visceral arterial aneurysms. In: Strandness DE, van Breda A (eds) Vascular diseases: surgical and interventional therapy. Churchill Livingstone, New York, pp 811–813

    Google Scholar 

  27. Piffaretti G, Tozzi M, Lomazzi C et al (2007) Splenic artery aneurysms: postembolization syndrome and surgical complications. Am J Surg 193:166–170

    Article  PubMed  Google Scholar 

  28. Larson RA, Solomon J, Carpenter JP (2002) Stent graft repair of visceral artery aneurysms. J Vasc Surg 36:1260–1263

    Article  PubMed  Google Scholar 

  29. Ruffino M, Rabbia C (2011) Endovascular treatment of visceral artery aneurysms with cardiatis multilayer flow modulator: preliminary results at six-month follow-up. J Cardiovasc Surg (Torino) 52:311–321

    CAS  Google Scholar 

  30. Sessa C, Tinelli G, Porcu P et al (2004) Treatment of visceral artery aneurysms: description of a retrospective series of 42 aneurysms in 34 patients. Ann Vasc Surg 18:695–703

    Article  PubMed  Google Scholar 

  31. Boudghene F, L’Hermine C, Bigot JM (1993) Arterial complications of pancreatitis: diagnostic and therapeutic aspects in 104 cases. J Vasc Interv Radiol 4:551–558

    Article  PubMed  CAS  Google Scholar 

  32. Belli AM, Markose G, Morgan R (2011) The role of interventional radiology in the management of abdominal visceral artery aneurysms. Cardiovasc Intervent Radiol. doi:10.1007/s00270-011-0201-3

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Acknowledgment

Supported in part by a CIRSE Foundation Fellowship grant 2011 (to S.S.).

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Interventional Radiology, Guy’s and St Thomas’ Hospitals NHS Trust, 1st Floor Lambeth Wing, St Thomas’ Hospital, Westminster Bridge Road, London, SE1 7EH, UK

    Stavros Spiliopoulos, Tarun Sabharwal, Miltiadis Krokidis, Panagiotis Gkoutzios & Andreas Adam

  2. Department of Diagnostic and Interventional Radiology, Patras University Hospital, Rion, Greece

    Stavros Spiliopoulos, Dimitrios Karnabatidis, Konstantinos Katsanos & Dimitrios Siablis

  3. 2nd Radiology Department, Attikon University Hospital, Haidari, Athens, Greece

    Elias Brountzos

Authors
  1. Stavros Spiliopoulos
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  2. Tarun Sabharwal
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  3. Dimitrios Karnabatidis
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  4. Elias Brountzos
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  5. Konstantinos Katsanos
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  6. Miltiadis Krokidis
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  7. Panagiotis Gkoutzios
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  8. Dimitrios Siablis
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  9. Andreas Adam
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Correspondence to Stavros Spiliopoulos.

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Spiliopoulos, S., Sabharwal, T., Karnabatidis, D. et al. Endovascular Treatment of Visceral Aneurysms and Pseudoaneurysms: Long-term Outcomes from a Multicenter European Study. Cardiovasc Intervent Radiol 35, 1315–1325 (2012). https://doi.org/10.1007/s00270-011-0312-x

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  • DOI: https://doi.org/10.1007/s00270-011-0312-x

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