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Rupture Risk and Etiology of Visceral Artery Aneurysms and Pseudoaneurysms: A Single-Center Experience
1Vascular Surgery, Department of Vascular Surgery, University Hospital, Erlangen, Germany susanne.regus@uk-erlangen.de.
Background:
The aim of this study was to analyze differences in rupture risk and etiology of visceral artery aneurysms (VAAs) and visceral artery pseudoaneurysms (VAPAs) in a single-center experience.
Materials And Methods:
We retrospectively reviewed all patients with a VAA or VAPA after treatment by open surgical or endovascular repair (ER) in our institution. Patient history, treatment details, and outcome were recorded and analyzed.
Results:
From January 1996 to April 2014, 29 (12 women) patients with 33 aneurysms (26 VAAs and 7 VAPAs) were treated in elective and urgent settings by open repair or ER. Etiology was quite different, most common was atherosclerosis (61.5%) in VAA and chronic pancreatitis (85.7%) in VAPA. Rupture rate was 19.2% in VAA and 42.9% in VAPA, whereas mean size of ruptured VAA was 4.4 cm and of ruptured VAPA was 2 cm. Open repair (suture, ligation, and aneurysmectomy with or without arterial reconstruction) and ER (coil embolization in the packing technique) were performed in half of all cases. After follow-up (72-month VAA and 82-month VAPA), aneurysm-free survival was reported to be 95% in VAA and 100% in VAPA.
Conclusion:
Chronic pancreatitis seems to be a prominent risk factor for the development of VAPA in this single-center experience. Modern endovascular techniques with promising short- and long-term results could broaden indications to treat asymptomatic VAA and VAPA.
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