Author: Guo Qiang

Affiliation: West China Hospital, Sichuan University

Introduction to Visceral Artery Aneurysms

Visceral artery aneurysms (VAAs) are rare but critical conditions that can lead to severe outcomes if ruptured. The document highlights that VAAs comprise only 0.1%-2% of all aneurysms but have a significant risk of rupture and mortality ranging from 14% to 100%.

Types and Locations of VAAs

· Splenic Artery Aneurysms: Most common, accounting for about 60% of all VAAs. Women are more frequently affected, with a male to female ratio of 1:4.

· Hepatic Artery Aneurysms: Account for 20% of VAAs, with the highest rupture rate at approximately 44%.

· Superior Mesenteric Artery Aneurysms: Often associated with bacterial infection, carrying a high mortality rate upon rupture.

· Celiac Trunk Aneurysms: More common in males; 40% have concurrent other visceral artery aneurysms, and 25% present with a rupture in a sequence known as "double rupture."

Diagnostic and Treatment Approaches

· Endovascular Treatment: Includes techniques such as coil embolization, covered stent placement, and multilayer bare stent deployment. It is preferred for patients who are high-risk surgical candidates or have complex anatomical considerations.

· Open Surgical Repair: Indicated for aneurysms close to the splenic hilum or abdominal trunk, or when concomitant abdominal pathologies are present that can be addressed simultaneously.

Case Studies and Outcomes

· Individual Cases: Descriptions of various cases treated with different methods, highlighting the indications for each approach and the outcomes achieved.

· Treatment Selection: Based on the aneurysm's size, location, and the patient's overall health status. Aneurysms larger than 2 cm in diameter or symptomatic aneurysms are generally considered for intervention.

Innovations and Clinical Insights

· The use of individualized treatment plans based on the unique characteristics of the aneurysm and the patient has led to successful management of these potentially life-threatening conditions.

· The document stresses the importance of early detection and personalized treatment strategies to improve clinical outcomes.

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