Visceral Artery Aneurysms: A 40-Year Experience from a Single Center.

BACKGROUND

Visceral artery aneurysms (VAAs) are a relatively uncommon phenomenon, and all types of VAA occur at an incidence of 0.01% to 0.2%. The present study aims to describe the clinical characteristics and treatment outcomes of patients with VAAs treated at a Chilean academic institution over the past 40 years.

METHODS

Single-center retrospective study of patients with VAAs surgically treated between August 1982 and May 2023. Data encompassing patient demographics, aneurysm characteristics, treatment modalities, and outcomes were analyzed.

RESULTS

The cohort included 59 patients with 64 aneurysms, predominantly female (n = 35, 59.3%) with a median age of 51 years (range: 21-86 years). The most common VAAs were localized in the renal (n = 32, 50.0%) and splenic arteries (n = 20, 31.3%). Endovascular procedures were performed in 27 (42.2%) cases and open surgery in 37 (57.8%) cases. Two (3.1%) cases were treated with renal autotransplantation, aneurysmectomy was performed in three (4.7%) cases, prosthetic bypass in 10 cases (15.6%), and vein bypass in 22 cases (34.4%). Embolization was employed in 21 cases (32.8%), covered stenting in 5 cases (7.8%), and one case (1.6%) received both embolization and stenting. Technical success was 100% in the endovascular group versus 97.0% in the open group (P = 0.387). Overall, the complication rate was 6.7% (n = 4) with a 30-day mortality rate of 2.1% (n = 1). The median follow-up was 60.5 months (6-318 months), with a long-term mortality rate of 5.0% (n = 3). Patients operated on during the first time frame era, before the endovascular era, (1982-2002) had larger aneurysms than those operated on in the second time frame (2003-2023), with a median size of 30 mm versus 23 mm, respectively (P < 0.04).

CONCLUSION

In the present study, both open repair and endovascular repair had similar surgical outcomes; however, the shift seen over time toward endovascular interventions aligns with current trends favoring less invasive procedures.