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Nonoperative management of peripancreatic arterial aneurysms. A 10-year experience
Insights
Embolization offers a safer alternative for bleeding visceral artery aneurysms, achieving a 79% success rate with no mortality. This interventional radiology technique is a viable option compared to high-risk surgery.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Gastroenterology
Background:
- Bleeding visceral artery aneurysms present a significant surgical challenge with high mortality rates (16-50%).
- Treatment decisions are often influenced by aneurysm location and etiology.
- Traditional surgical repair carries substantial risks.
Observation:
- A 10-year study reviewed nineteen patients with bleeding visceral artery aneurysms.
- All patients underwent definitive treatment via embolization.
- Common causes included pancreatitis (13 patients), trauma (4 patients), and others.
Findings:
- Embolization demonstrated a high success rate of 79% in definitively treating these aneurysms.
- Crucially, no mortality was observed in the embolization group.
- This contrasts sharply with the high mortality associated with surgical intervention.
Implications:
- Embolization represents a minimally invasive and effective treatment modality for visceral artery aneurysms.
- This approach significantly reduces patient mortality compared to open surgery.
- Interventional radiology should be considered a primary treatment option for these complex vascular lesions.
Abstract:
The surgical approach to bleeding visceral artery aneurysms has a mortality rate of 16-50% that is dependent primarily on anatomic location and underlying cause. Nineteen patients were studied over a 10-year period who were definitively treated by embolization. There was a 79% success rate and no mortality. The cause of the aneurysms was pancreatitis in 13 patients, trauma in four patients, subacute bacterial endocarditis in one patient, and secondary to biliary tract surgery in one patient.