Retrospective Study of Miscellaneous Small Visceral Artery Aneurysms: Results of a Single Center-6-Year Surveillance

Visceral artery aneurysms (VAAs) are rare with a reported incidence of 0.1 to 2%. However, VAAs are clinically important and can present as life-threatening ruptures that require emergency treatment. The aim of this study was to review our experience with managing VAAs.

Retrospective analysis of a prospectively collected database was performed for 88 patients diagnosed with visceral artery aneurysm (VAA) over a 15-year period (2006-2021). Aneurysm size was compared over time using the repeated measures mixed effects model.

There were 108 VAAs identified in 88 patients, with a mean age of 74.7 years, SD 12.6 (age at presentation or first scan). Of these, 47 (43.5%) were splenic artery aneurysms with a median initial size of 15 mm, 36 (33.4%) were mesenteric artery aneurysms with a median initial size of 14.5 mm, and 25 (23.1%) were renal artery aneurysms with a median initial size of 11 mm. The overall initial median size of the VAA was 15 mm. There is no statistically significant correlation between aneurysm growth rate and any medications or comorbidities. In 88 patients, small VAAs (≤25 mm) were monitored with surveillance imaging with mean surveillance time of 72.7 months and median time of 65 months.

This study confirms that VAAs <25 mm do not show significant expansion. The important message is that none of the 88 patients' VAAs increased in size to require treatment. Our study suggests that it may be safe to extend the surveillance interval for small VAAs to 5 years.