The Minimally Invasive Treatment of Visceral Arter Aneurysms

Purpose: The aim of our study is to analyze the safety and efficacy of different minimally invasive treatment techniques of visceral artery aneurysms (VAA).

Materials and Methods: Patients who underwent minimally invasive treatment (endovascular, laparoscopic) for VAA at Almazov National Medical Research Centre between 2017 and 2023 were enrolled in this retrospective study. We collected and statistically analyzed demographic, clinical, VAA-specific data as well as information on therapy, early and long-term outcomes.

Results: Nineteen patients, 12 females and 7 males with a median age of 49 years (range 32–72 years), were diagnosed with VAA. The localizations were: splenic artery (N = 16; 84.2%), renal artery (N = 2; 10.5%), superior mesenteric artery (N = 1; 5.3%). Six patients (26%) underwent laparoscopic surgery with endoscopic linear cutter whereas thirteen patients (69%) received an endovascular treatment. Coiling was used twice (75%) and stent-graft implantation in others cases. Successful treatment rate was 94.7% (18/19 patients). In one case of laparoscopic management, there was conversion to open access as a result of intraoperative rupture of the aneurysm. Complete occlusion was demonstrated during follow up (mean 33 months, range 6–72) in the 18 patients with technical success. There were no stent-grafts and coils migration and stent-grafts thrombosis. Three patients (15.8%) had an acute splenic infarction, two of them underwent splenectomy. Mortality rate was 0% in 30-day and other follow-ups.

Conclusion: In our study, different techniques of minimally invasive treatment of visceral aneurysms has demonstrated to be safe and is effective in the long-term, with a high rate of successful treatment and a low complication rate. Localization, anatomy and the end-organ perfusion after intervention or operation are the most important aspects to consider when planning a treatment for VAA. For this reason, a multidisciplinary evaluation of every individual patient is necessary for an optimized outcome.

Publication History

Article published online:
02 April 2024