Cost-effectiveness of endovascular repair, open repair, and conservative management of splenic artery aneurysms

Abstract

EV is the most cost-effective treatment for most patient groups with SAAs, independent of the sex and risk profile of the patient. EV is superior to OPEN, being both cost-saving and more effective in all age groups. Elderly patients should be considered for CONS, based on the high costs in relation to the very small gain in health when treated with EV. The very elderly should be treated with CONS.

Duplo aneurisma de artéria mesentérica superior: relato de caso

“…14 Open surgery is a management option for patients with low surgical risk ratings and, primarily, for those who are hemodynamically unstable and need emergency repair. 15 However, it is a highly invasive procedure with a significant mortality rate of 15%. 5 In general, proximal and distal ligature of the aneurysm is performed, followed by aneurysmectomy and reconstruction of the SMA with saphenous vein or synthetic graft (dacron, for example), the latter of which is only used when there is no evidence of infection.…”

“…16 This method is associated with low short-term morbidity rates, less postoperative pain, fewer operating site complications, shorter length of hospital stay, earlier return to daily activities, and improved quality of life. 15 However, there are also risks inherent to the method, such as iatrogenic dissection and rupture of the vessel, acute thrombosis, thromboembolization and infectious dissemination in cases with mycotic etiology. 5 Other disadvantages also include high reintervention rates, incomplete exclusion of the aneurysm, unknown durability over the long term, and the need for repeated imaging exams.…”

Ruptured gastric artery aneurysms: two cases and emergency imaging findings

“…In the setting of acute rupture with haemodynamic instability, open surgical management of visceral artery aneurysms is regarded by many authors as the treatment of choice. 8 Surgical treatment options include open or laparoscopic excision of the aneurysm. Vascular perfusion may or may not be re-established, or the affected organ removed ( i.e.…”

Another complication of cirrhosis

“…Open surgery is associated with longer intraoperative time and length of hospital stay and higher rates of 30day mortality and perioperative morbidity. [38][39][40][41] With endovascular repair, the complication of persistent or recurrent flow occurs in 3% to 5% of cases by 30 days; hence, postprocedural surveillance is recommended. [42][43][44] Endovascular repair has a higher reintervention rate but may still be more cost-effective than open surgical repair.…”