Clinical Profile, Management, and Outcome of Visceral Artery Pseudoaneurysms: 5-Year Experience in a Tertiary Care

Faiz Altaf Shera1, Tahleel Altaf Shera1, Naseer Ahmad Choh1

  • 1Department of Radio-diagnosis and Imaging, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India.

Insights

Visceral artery pseudoaneurysms are dangerous but treatable. Minimally invasive endovascular embolotherapy offers high success rates and fewer complications compared to surgery or no intervention, significantly improving patient outcomes.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Gastroenterology

Background:

  • Visceral artery pseudoaneurysms (VAPs) are life-threatening vascular lesions with a high risk of rupture.
  • Prompt intervention is crucial for managing VAPs.
  • Common etiologies include pancreatitis, trauma, and post-surgical complications.

Purpose of the Study:

  • To review the experience with splanchnic visceral artery pseudoaneurysms.
  • To analyze the etiology, clinical presentation, management, and outcomes.
  • To compare the effectiveness of endovascular versus surgical interventions.

Main Methods:

  • Retrospective study of 27 patients with VAPs over a 5-year period.
  • Data collected from hospital image database and medical records.
  • Analysis of vessel of origin, size, etiology, clinical features, treatment, and outcome.

Main Results:

  • Pancreatitis, surgery, and trauma were the most common causes of VAPs.
  • Fifteen patients were managed with endovascular embolotherapy, 6 with surgery, and 6 received no intervention.
  • Endovascular treatment achieved 100% technical and clinical success with minor complications.
  • Surgery and no intervention were associated with high mortality rates (66% and 50%, respectively).

Conclusions:

  • Visceral pseudoaneurysms are frequently caused by pancreatitis, surgery, or trauma.
  • Minimally invasive endovascular embolotherapy is a highly effective and safe treatment for VAPs.
  • Surgical intervention and conservative management are linked to increased morbidity and mortality.

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