Endovascular treatment of visceral aneurysms and pseudoaneurysms: long-term outcomes from a multicenter European study
Related Experiment Videos
Stavros Spiliopoulos1, Tarun Sabharwal, Dimitrios Karnabatidis
1Department 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. stavspiliop@upatras.gr
Insights
Percutaneous endovascular management of visceral aneurysms (VA) and visceral pseudoaneurysms (VPA) is a safe and effective treatment. While successful in all cases, a small reintervention rate necessitates dedicated follow-up imaging.
Area of Science:
- Interventional Radiology
- Vascular Surgery
- Endovascular Therapy
Background:
- Visceral aneurysms (VA) and visceral pseudoaneurysms (VPA) are rare but serious vascular conditions.
- Endovascular management offers a minimally invasive approach to treating these complex pathologies.
Purpose of the Study:
- To evaluate the safety and efficacy of percutaneous endovascular treatment for visceral aneurysms and pseudoaneurysms.
- To assess procedural success, reintervention rates, and complications in a multi-center European study.
Main Methods:
- Retrospective analysis of patient data from three European interventional radiology departments (2000-2010).
- Inclusion criteria: confirmed VA/VPA treated exclusively with percutaneous endovascular methods.
- Primary endpoints: technical success, reintervention rate, periprocedural mortality. Secondary endpoints: complication rates.
Main Results:
- 54 patients with 58 visceral aneurysms/pseudoaneurysms were treated.
- 100% procedural technical success was achieved.
- Reintervention rates were 6.1% for VPA and 14.2% for VA. Periprocedural mortality was 3% for VPA and 0% for VA.
Conclusions:
- Percutaneous endovascular treatment of visceral aneurysms and pseudoaneurysms is safe and effective.
- Low morbidity and mortality rates were observed.
- A small but significant reintervention rate, especially for true aneurysms, highlights the need for dedicated follow-up imaging.
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.
Related Concept Videos
01:26Aneurysm III: Interprofessional Care
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies