Clinical Profile, Management, and Outcome of Visceral Artery Pseudoaneurysms: 5-Year Experience in a Tertiary Care Hospital

Abstract

Visceral artery pseudoaneurysms are potentially lethal lesions and tend to rupture in a high proportion of cases, thereby warranting an immediate and active intervention.We present our experience of splanchnic visceral artery pseudoaneurysms in a university hospital over a 5-year time interval with emphasis on etiology, clinical presentation, management (endovascular/surgical), and final outcome.This was a retrospective study in which we searched our image database for pseudoaneurysms of visceral arteries over a period of 5 years. The clinical and operative details were retrieved from the medical record section of our hospital. The lesions were analyzed for the vessel of origin, size, etiology, clinical features, mode of treatment, and outcome.Twenty-seven patients with pseudoaneurysms were encountered. Pancreatitis (8) was the most common cause, followed by previous surgery (7) and trauma (6). Fifteen were managed by the interventional radiology (IR) team, 6 by surgery, and in 6 no intervention was done. Technical and clinical success was achieved in all patients in the IR group with few minor complications. Surgery and no intervention carry a high mortality in such a setting (66 and 50%, respectively).Visceral pseudoaneurysms are potentially fatal lesions, commonly encountered after trauma, pancreatitis, surgeries, and interventional procedures. These lesions are easily salvageable by minimally invasive interventional techniques (endovascular embolotherapy), and surgeries carry a lot of morbidity and mortality in such cases and a prolonged hospital stay.

Endovascular and Open Surgical Treatment of Ruptured Splenic Artery Aneurysms: A Case Report and a Systematic Literature Review

“…First, the heterogeneity of the data, which come mainly from case reports, case series, and portions of larger comparative studies conducted on VAAs, from which the data regarding r-SAAs and r-SAPAs were extracted. This also causes a wide heterogeneity in how results were reported and resulted in us excluding many studies in which the specific outcomes of r-SAAs and r-SAPA were not clearly provided [ 235 , 236 , 237 ]. In fact, the largest and most interesting studies on this topic report on VAAs considered as a whole, sometimes conducting subgroup analysis by aneurysm location or by symptomatic/asymptomatic presentation; visceral artery aneurysms should be seen instead as separated identities, each with its peculiarities, because of the differences in anatomy and physiology of the abdominal organs they supply.…”

Endovascular Treatment of Visceral Artery Pseudoaneurysms with Ethylene-Vinyl Alcohol (EVOH) Copolymer-Based Non-Adhesive Liquid Embolic Agents (NALEAs)

“…Visceral artery pseudoaneurysms (VAPs) are critical vascular abnormalities originating from the splanchnic circulation, often attributed to inflammatory, infectious, traumatic, iatrogenic, and neoplastic etiologies [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ]. Distinct from true aneurysms, pseudoaneurysms arise from the disruption of the intimal and medial layers of the arterial wall, lacking an epithelized wall structure [ 14 ].…”