Objective: Visceral artery aneurysms, despite being uncommon,
are important vascular diseases, since they frequently are lifethreatening,
and often fatal emergencies. The purpose of this study is
to review our experience with treatments of visceral artery aneurysms.
Method: Between 1988 and June, 2004, 37 visceral artery
aneurysms were treated in 35 patients (17 male and 18 female) with
average age of 56 ± 14 years. The most common locations were the
splenic artery (18), the hepatic artery (10) and the superior mesenteric
artery (four). 22 patients were asymptomatic, 13 patients were
symptomatic. Emergency surgery was performed on three patients,
elective open surgery on 29 patients, and endovascular treatment on
seven patients.
Results: Perioperative mortality rate was 3.1% in the surgical
group. The perioperative morbidity rate was 5.7%: one case of
respiratory distress and one case of bilious fistula were manifested in
the immediate postoperative period. None of the patients died in the
endovascular group; perioperative morbidity rate was 14.3% (one case
of hepatic artery thrombosis after failure of gastroduodenal artery
aneurysm embolization). Failure of the procedure was 42.9% (three
cases of aneurysm recanalization).
Conclusion: We believe that an aggressive surgical approach is
justified even in case of asymptomatic visceral artery aneurysms, due
to the low morbidity/mortality rates. Endovascular treatment should
be reserved to selected cases.