Stent-Graft Repairs of Visceral and Renal Artery Aneurysms Are Effective and Result in Long-term Patency

• Published in: Journal of vascular and interventional radiology Vol. 24; no. 7; pp. 989 - 996
• Main Authors: Künzle, Stefan, MD, Glenck, Michael, MD, Puippe, Gilbert, MD, Schadde, Erik, MD, Mayer, Dieter, MD, Pfammatter, Thomas, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2013
• Subjects: Adult; Aged; Aged, 80 and over; Aneurysm - diagnosis; Aneurysm - mortality; Aneurysm - physiopathology; Aneurysm - surgery; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation - adverse effects; Blood Vessel Prosthesis Implantation - instrumentation; Blood Vessel Prosthesis Implantation - mortality; Endovascular Procedures - adverse effects; Endovascular Procedures - instrumentation; Endovascular Procedures - mortality; Female; Graft Occlusion, Vascular - diagnostic imaging; Graft Occlusion, Vascular - etiology; Graft Occlusion, Vascular - physiopathology; Graft Occlusion, Vascular - therapy; Hospital Mortality; Humans; Male; Middle Aged; Radiology; Renal Artery - diagnostic imaging; Renal Artery - physiopathology; Renal Artery - surgery; Retrospective Studies; Stents; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Vascular Patency; Viscera - blood supply; visceral artery aneurysm; VAA
• ISSN: 1051-0443; 1535-7732
• DOI: 10.1016/j.jvir.2013.03.025

Abstract Purpose To report on the long-term outcomes of endovascular exclusion of visceral and renal artery aneurysms with the use of stent-grafts. Materials and Methods Nineteen consecutive patients (mean age, 59 y ± 16 [standard deviation]) with a total of 19 visceral artery aneurysms (VAAs; hepatic, n = 6; celiac, n = 4; renal, n = 4; splenic, n = 3; and superior mesenteric, n = 2) were electively (n = 9) or emergently (n = 10) treated with a variety of stent-grafts. The etiology of aneurysms was variable: postoperative (n = 9), infectious (n = 3), idiopathic (n = 4), Ehlers–Danlos syndrome (n = 2), and α1-antitrypsin deficiency (n = 1). The patients were followed up with clinical examinations and computed tomographic (CT) angiography. Results No patient was lost to follow-up. The in-hospital mortality rate was 11% (n = 2). Three patients died of cancer after successful VAA treatment. At the last follow-up, the remaining 14 patients were alive and well. Three patients refused follow-up CT angiography. CT angiography demonstrated stent-graft patency at a mean follow-up of 28 months (range, 2–100 mo) in nine of 11 remaining patients (82%) and thrombosis in two patients (one with a splenic and one with a renal artery stent-graft). These events were asymptomatic. All aneurysms decreased in size. Late repeat intervention was performed to treat a celiac restenosis in a patient with a hepatic stent-graft. Conclusions Irrespective of their etiology and acuteness, VAAs can be treated with stent-grafts, with an excellent clinical long-term outcome and a high patency rate.