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Current management strategies for visceral artery aneurysms: an overview

Visceral artery aneurysms (VAAs) are rare and affect the celiac artery, superior mesenteric artery, and inferior mesenteric artery, and their branches. The natural history of VAAs is not well understood as they are often asymptomatic and found incidentally

Recent advances in imaging technology and its availability allow us to diagnose all types of VAA. VAAs can be treated by open surgery, laparoscopic surgery, endovascular therapy, or a hybrid approach. However, there are still no specific indications for the treatment of VAAs, and the best strategy depends on the anatomical location of the aneurysm as well as the clinical presentation of the patient.

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  Visceral Artery Aneurysms

These types of aneurysms are uncommon and usually found incidentally or when other imaging tests are done. After they are found they are often followed with imaging and fixed... The most common type of visceral aneurysm is the splenic artery aneurysm. Depending on where exactly they are located, these aneurysms can be treated endovascularly (through the blood vessel) with stents to cover the aneurysm or coils to occlude the vessel. Open surgery however sometimes is required with resection of the aneurysm +/- replacement with a graft.

 Endovascular Management of Visceral Artery Aneurysms

Endovascular treatment options include end-artery embolization, stent- or balloon-assisted coiling, direct aneurysm coiling, use of liquid embolic agents, flow-diverting stents, and (rarely) percutaneous thrombin injection.

 SVS releases new clinical practice guidelines on visceral artery aneurysms

With the increased use of sophisticated forms of intra-abdominal imaging, including magnetic resonance imaging and angiography (MRI, MRA) and computerised tomographic scans and angiography (CT, CTA), occult visceral artery aneurysms are being diagnosed with increased frequency.

Articles of Interest

Visceral artery aneurysms

Visceral artery aneurysms are rare with an incidence of approximately 0.01–0.1% in the population. Aneurysms of the splenic artery are the most common, followed by the hepatic artery and the superior and inferior mesenteric arteries.

Visceral artery aneurysms – classification, diagnosis and treatment

Visceral artery aneurysms are believed to be rare, but their detectability has been increasing with the development of imaging modalities. Ultrasound is the first test conducted for diagnosing splanchnic aneurysms and monitoring asymptomatic lesions. Endovascular procedures are effective for both asymptomatic and ruptured visceral artery aneurysms.

Visceral Artery Aneurysms: Review of Current Management Options

Endovascular techniques have gained popularity and have become the first-line treatment for certain types of aneurysms, such as those that affect the mid- to proximal splenic artery.

Celiac Arterial Aneurysms A Critical Reappraisal of a Rare Entity

To our knowledge, no true incidence figures are available; however, aneurysmal degeneration of the celiac artery appears to be the fourth most commonly affected of the visceral arteries. The potential risk for rupture of these rare aneurysms has been reported to be quite low. However, most series are small and the true incidence of rupture remains elusive.

Celiac Artery Aneurysm

Aneurysm of the celiac artery is an uncommon clinical problem; fewer than 180 cases have been reported in the world medical literature. Most patients are symptomatic at the time of diagnosis. However, occasionally such aneurysms are detected incidentally during diagnostic imaging for other diseases.

Peripheral and Visceral Artery Aneurysms

Splenic artery aneurysms are the most common type of visceral aneurysm, comprising around 60% of the total.

Ruptured Visceral Artery Aneurysms: A Deadly Cause of Epigastric Pain

Visceral artery aneurysms (VAA) are life-threatening and often require immediate intervention upon rupture. The arteries most commonly affected by VAAs are the following: hepatic, splenic, superior mesenteric, and the celiac. Each vessel has unique risk factors and epidemiologic characteristics that can help to narrow down which of the four may be involved. Risk of rupture and mortality rates of these vessels are high, especially in pregnancy.

Resources

Celiac Artery Aneurysm Support Group

At first I was not willing to call this a support "group" until we get 10 members. Anything less than 10 and at most you're just a couple of people loitering. A little about me. I'm 48, male. I have fibromuscular dysplasia along with celiac compression syndrome and of course a celiac artery aneurysm (and stenosis). Just looking for other people who have gone through searching for help and hoping to pool resources.

Radiopaedia

Visceral artery aneurysms are usually degenerative and related to a deficiency of the arterial media with loss of elastic fibers and reduced smooth muscle. Other possible causes are atherosclerosis, fibromuscular dysplasia, collagen disorders, trauma, inflammation, infection, or vasculitis 1. Pancreatitis may promote the destruction of the arterial wall resulting in pseudoaneurysms of related visceral arteries. Segmental arterial mediolysis is also an increasingly recognized cause.

Society for Vascular Surgery

This type of aneurysm is uncommon. Successful treatment with catheter-based or conventional (open) surgery relieves symptoms and should remedy the problem. Visceral aneurysms, like other aneurysms in the body, are not treated until they reach a certain size or cause symptoms. The size threshold varies with gender and age, but few aneurysms under 2 cm are treated.