Open Surgical Management of Celiac Trunk and Hepatic Artery Aneurysms: A Case Series

BackgroundVisceral artery aneurysms (VAAs) are uncommon vascular lesions, representing less than 2% of all arterial aneurysms, yet they carry significant clinical relevance owing to their frequently silent course and potential for catastrophic rupture. Within this group, celiac trunk aneurysms (CTAAs) and hepatic artery aneurysms (HAAs) constitute a minority of cases but pose distinct diagnostic and therapeutic challenges. Endovascular therapy has gained prominence in recent years; however, open surgical repair remains an essential treatment modality, particularly in complex anatomical settings or when endovascular options are unsuitable.MethodsWe present a case series of 3 patients managed at our institution: 2 with CTAAs and 1 with an HAA. All patients underwent open surgical repair using tailored vascular reconstruction strategies, including splenic artery interposition, aorto-hepato-splenic bypass with a great saphenous vein graft, and superficial femoral artery interposition. Patient selection and operative planning were guided by preoperative imaging, aneurysm morphology, and comorbid conditions.ResultsThere was no perioperative mortality. Major postoperative complications occurred in 2 cases, including gastric ischemia requiring total gastrectomy and postoperative hematoma requiring re-exploration. At 1-year follow-up, all patients demonstrated 100% graft patency and preserved end-organ perfusion.ConclusionsThis experience highlights the importance of individualized surgical decision-making in the management of VAAs. While the rarity of these lesions limits large-scale comparative studies, our series reinforces that open surgical repair remains a safe and durable option when tailored to patient-specific anatomy. In the era of endovascular techniques, elective open surgical repair remains associated with low mortality and high technical success when performed by an experienced surgical team, offering satisfactory early and mid-term outcomes.