Endovascular treatment of visceral artery aneurysms and pseudoaneurysms: our experience

Radiol Med. 2012 Aug;117(5):815-30. doi: 10.1007/s11547-011-0776-4. Epub 2012 Jan 7.

Abstract

Purpose: The aim of this study was to analyse our 8 years of experience with endovascular treatment of visceral aneurysms and pseudoaneurysms.

Materials and methods: From January 2002 to September 2009, we used an endovascular approach to treat 30 patients (22 men, eight women) affected by aneurysm (n=18) or pseudoaneurysm (n=13) of the splenic (n=11), hepatic (n=6), renal (n=5), pancreaticoduodenal (n=3), left gastric (n=2), gastroduodenal (n=1), rectal (n=1) or middle colic (n=1) arteries and the coeliac axis (n=1). Of these, 26/31 were treated with metal coils, 3/31 with Cardiatis multilayer stent, 1/31 with a coated stent and 1/31 with coils and Amplatzer plug. Procedures were performed electively in 10/30 cases and during haemorrhage in 20/30 cases. Follow-up was performed clinically (cessation of bleeding) and at 1, 6 and 12 months by colour-Doppler ultrasound (CDUS) and computed tomography (CT) angiography.

Results: In 31/31 aneurysms and pseudoaneurysms we obtained immediate exclusion. In four patients with aneurysm and in four with pseudoaneurysm, parenchymal ischaemia occurred; one was treated with surgical splenectomy. One patient with pseudoaneurysm of the coeliac axis died 10 days later because of new bleeding. During follow-up, all aneurysms and pseudoaneurysms remained excluded.

Conclusions: Percutaneous treatment is effective and safe, with a small number of complications, especially when compared with traditional surgery.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aneurysm / diagnostic imaging
  • Aneurysm / surgery*
  • Aneurysm, False / diagnostic imaging
  • Aneurysm, False / surgery*
  • Blood Vessel Prosthesis Implantation / methods*
  • Endovascular Procedures*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ultrasonography, Doppler, Color
  • Viscera / blood supply*