Visceral artery pseudoaneurysms: An institutional experience
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 2, Pages 2044-2050
AbstractPurpose: Visceral artery pseudo-aneurysms were infrequently encountered in clinical practice. With the advent of higher resolution imaging, VAPA has been diagnosed more frequently and promptly. Though the natural history of this pathology is not fully elucidated, they can present with devastating complications. This study is one of the few large case series exclusively describing visceral artery pseudo-aneurysm offering a glimpse in to various etiologies, presentations, and treatment approaches for visceral artery pseudo-aneurysms in a specialized care center.
Material and Methods: Medical records of patients with visceral artery pseudo-aneurysms between January 2015 to May 2020 were retrieved, and data pertaining to etiology, clinical presentation, imaging, and management were compiled and analyzed.
Results: During the study period 29 visceral artery pseudo-aneurysms were identified in 27 patients (2 patients had more than one VAPA). They had diverse etiology, location, and presentation. The splenic artery was the most common site of VAPA (n=10). The commonest etiology was pancreatitis (41%). Only 7 patients were asymptomatic while the majority had symptoms (n=20). Abdominal pain was the most frequent symptom (66%) followed by gastrointestinal bleeding (30%). 16 patients were successfully treated by endovascular intervention, while 2 patients required surgical intervention. No morbidity or mortality was noted during the period of hospitalization.
Conclusion: Visceral artery pseudo-aneurysms can be secondary to plethora of pathologies. A high degree of suspicion with prompt imaging helps in timely diagnosis. Endovascular interventions are highly effective treatment modalities for visceral artery pseudo-aneurysms. It should be considered as the preferred modality of treatment in anatomically suited VAPA.
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