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Visceral artery aneurysms, though rare, are increasingly diagnosed. Surgical intervention is recommended for splenic and renal artery aneurysms based on specific criteria, while hepatic artery aneurysms require prompt treatment.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Abdominal Imaging
Background:
- Visceral artery aneurysms (VAAs) are rare but increasingly detected, often due to advanced imaging techniques.
- Splenic artery aneurysms are most common, followed by renal and hepatic artery aneurysms.
Purpose of the Study:
- To review the diagnostic trends and management strategies for visceral artery aneurysms.
- To delineate indications for surgical versus endovascular treatment of different VAA types.
Main Methods:
- Review of clinical data and imaging findings for patients diagnosed with visceral artery aneurysms.
- Analysis of treatment outcomes for surgical and transcatheter arterial embolization (TAE) interventions.
Main Results:
- Splenic and renal artery aneurysms warrant surgery if symptomatic, growing, >2 cm, or found in pregnant/child-bearing age women.
- Hepatic and rarer VAAs necessitate immediate surgical treatment due to high rupture risk.
- Transcatheter arterial embolization is a viable alternative for high-risk patients.
Conclusions:
- Management of VAAs requires careful consideration of aneurysm location, size, symptoms, and patient factors.
- Prompt treatment is crucial for hepatic and rare VAAs to prevent rupture.
- Endovascular embolization offers a less invasive option for select VAA cases.
Abstract:
Although rare, visceral artery aneurysms are reported with increasing frequency, mostly as a result of the growing use of angiography in unclear cases of abdominal symptoms. The splenic artery aneurysms are by far the most common, followed in frequency by the renal and hepatic artery aneurysms. The splenic and renal artery should undergo surgery in all cases of symptomatic aneurysms, asymptomatic aneurysms discovered in pregnant women or women of child-bearing age, aneurysms with documented growth, and aneurysms with a diameter more than 2 cm. The hepatic artery aneurysms as well as the more rare aneurysms should be treated surgically as soon as the diagnosis is established because the natural course of these aneurysms seems to be progression to rupture. In high risk patients, transcatheter arterial embolisation has recently proven to be a useful alternative to surgery in many cases.