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Published on: September 8, 2023
Endovascular and open repair of visceral aneurysms: A retrospective single‑center analysis
Artur Rebelo1, Ulrich Ronellenfitsch1, Jumber Partsakhaschwilli1
1Department of Visceral, Vascular and Endocrine Surgery, Martin-Luther-University Halle-Wittenberg, D-06120 Halle (Saale), Germany.
Insights
Endovascular repair (ER) for visceral aneurysms (VAA) shows no mortality and a shorter hospital stay compared to open surgery. This supports ER as a preferred treatment, though selection bias is possible.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Gastroenterology
Background:
- Visceral aneurysms (VAA) are rare but serious conditions.
- Treatment options include open surgical repair and endovascular repair (ER).
- Outcomes comparing these approaches require further analysis.
Purpose of the Study:
- To compare the outcomes of open surgical and endovascular interventions for visceral aneurysms.
- To evaluate postoperative mortality, morbidity, procedure duration, technical success, and length of hospital stay.
Main Methods:
- Retrospective review of 12 visceral aneurysm patients treated at a single tertiary referral center.
- Adherence to STROBE guidelines for observational studies.
- Analysis of primary endpoint: postoperative in-hospital mortality.
- Analysis of secondary endpoints: major morbidity, procedure duration, technical success, and length of hospital stay.
Main Results:
- No 30-day mortality or major morbidity observed in either treatment group.
- Median aneurysm diameter was 2.0 cm.
- Median postoperative hospital stay was 4 days.
- Significantly shorter hospital stay for endovascular repair (3 days) compared to open surgery (7 days).
Conclusions:
- Endovascular repair for visceral aneurysms demonstrates favorable outcomes with no mortality and reduced hospital stay.
- Results align with ER being a first-line treatment for VAA.
- Potential selection bias in the retrospective analysis warrants consideration.
Abstract:
The aim of the present study was to analyze the outcome of open surgical and endovascular interventions for the treatment of visceral aneurysms. A retrospective review of a cohort of visceral aneurysm patients treated at a single tertiary referral center was conducted. STROBE guidelines were followed. The primary endpoint was postoperative in-hospital mortality. Secondary endpoints were major morbidity (Dindo-Clavien score, >3), the duration of the procedure, technical success and the length of hospital stay. As a result, 12 patients underwent open or endovascular surgery. No 30-day mortality or major morbidity were observed. The median aneurysm diameter was 2.0 cm (range, 1.5-5.0 cm). The median postoperative stay was four days for all procedures and significantly longer after open surgery compared with endovascular repair (ER) (7 vs. 3 days). Overall, the evidence from the present retrospective analysis shows no mortality and a shorter length of stay for patients undergoing ER for the treatment of a visceral aneurysm (VAA). Although the results are in line with the fact that ER is considered to be the first line treatment for VAA, this may be prone to selection bias.
