Document Detail


Surgical treatment of visceral artery aneurysms: A 25-year experience.
MedLine Citation:
PMID:  18644480     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The aim of this study was to analyze our 25-year experience with surgical treatment of visceral artery aneurysms (VAAs), with particular attention paid to early and long-term results.
MATERIALS AND METHODS: From January 1982 to September 2007, 55 patients (32 males, 58%, and 23 females, 42%) underwent surgical treatment of 59 VAAs. Only one patient was treated with an endovascular procedure. Mean patient age was 59.3 years (range, 36-78 years). The site of aneurysmal disease was splenic artery in 30 (50.8%) cases, renal artery in nine (15.2%) cases, common hepatic artery in seven (11.9%) cases, pancreaticoduodenal artery in four (6.8%) cases, celiac trunk in three (5.1%) cases, superior mesenteric artery in two (3.4%) cases, and gastroduodenal, inferior mesenteric, middle colic and right gastroepiploic in one (1.7%) case for each artery. Two (3.6%) patients had multiple VAAs. In five (9.1%) patients, an abdominal aortic aneurysm coexisted. Early results in terms of mortality and major complications were assessed. Follow-up consisted of clinical and ultrasound examinations at 1 and 12 months, and yearly thereafter. Long-term results in terms of survival and aneurysm-related complications were analyzed.
RESULTS: In all but two cases, elective intervention in asymptomatic patients was performed. Two (3.6%) patients had a ruptured aneurysm (one pancreaticoduodenal artery and one middle colic artery). The one perioperative death was due to an acute pancreatitis in a patient operated on for a giant inflammatory splenic artery aneurysm, yielding a perioperative mortality rate of 1.8%. Two major complications (retroperitoneal hematoma and acute pancreatitis) were recorded. Mean duration of follow-up was 82.1 months (range, 0-324 months). Estimated 10-year survival rate was 79.5%. During follow-up two aneurysm-related complications occurred, with an estimated 10-year, aneurysm-related, complication-free survival rate of 75.2%.
CONCLUSION: In the era of minimally invasive therapeutic approaches, elective open surgical treatment of visceral artery aneurysms is safe and effective, and offers satisfactory early and long-term results.
Authors:
Raffaele Pulli; Walter Dorigo; Nicola Troisi; Giovanni Pratesi; Alessandro Alessi Innocenti; Carlo Pratesi
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  48     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-22     Completed Date:  2008-08-22     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  334-42     Citation Subset:  IM    
Affiliation:
Department of Vascular Surgery, University of Florence, Florence, Italy. rpulli@unifi.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aneurysm / mortality*,  radiography,  surgery*
Angiography / methods
Angioplasty / adverse effects,  methods*
Celiac Artery / radiography,  surgery
Cohort Studies
Female
Follow-Up Studies
Hepatic Artery / radiography,  surgery
Humans
Kaplan-Meier Estimate
Male
Mesenteric Artery, Superior / radiography,  surgery
Mesentery / blood supply*,  physiopathology,  surgery
Middle Aged
Postoperative Complications / epidemiology
Probability
Renal Artery / radiography,  surgery
Retrospective Studies
Risk Assessment
Severity of Illness Index
Splanchnic Circulation*
Splenic Artery / radiography,  surgery
Survival Analysis
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Vascular Surgical Procedures / adverse effects,  methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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