Visceral artery aneurysms (VAAs) are rare, usually asymptomatic and incidentally discovered during a routine radiological examination. Shared guidelines suggest their treatment in the following conditions: VAAs with diameter larger than 2 cm, or 3 times exceeding the target artery; VAAs with a progressive growth of at least 0.5 cm per year; symptomatic or ruptured VAAs. Endovascular treatment, less burdened by morbidity and mortality than surgery, is generally the preferred option. Selection of the best strategy depends on the visceral artery involved, aneurysm characteristics, the clinical scenario and the operator's experience. Tortuosity of VAAs almost always makes embolization the only technically feasible option. The present narrative review reports state of the art and new perspectives on the main endovascular and other interventional options in the treatment of VAAs. Embolization techniques and materials, use of covered and flow-diverting stents and percutaneous approaches are accurately analyzed based on the current literature. Visceral artery-related considerations and targeted approaches are also provided and discussed.

Visceral Artery Aneurysms Embolization and Other Interventional Options: State of the Art and New Perspectives

Venturini, Massimo;Piacentino, Filippo;Coppola, Andrea;Bettoni, Valeria;Macchi, Edoardo;Curti, Marco;Ossola, Christian;Piffaretti, Gabriele
Membro del Collaboration Group
;
Tozzi, Matteo;Carcano, Giulio;Fontana, Federico
2021

Abstract

Visceral artery aneurysms (VAAs) are rare, usually asymptomatic and incidentally discovered during a routine radiological examination. Shared guidelines suggest their treatment in the following conditions: VAAs with diameter larger than 2 cm, or 3 times exceeding the target artery; VAAs with a progressive growth of at least 0.5 cm per year; symptomatic or ruptured VAAs. Endovascular treatment, less burdened by morbidity and mortality than surgery, is generally the preferred option. Selection of the best strategy depends on the visceral artery involved, aneurysm characteristics, the clinical scenario and the operator's experience. Tortuosity of VAAs almost always makes embolization the only technically feasible option. The present narrative review reports state of the art and new perspectives on the main endovascular and other interventional options in the treatment of VAAs. Embolization techniques and materials, use of covered and flow-diverting stents and percutaneous approaches are accurately analyzed based on the current literature. Visceral artery-related considerations and targeted approaches are also provided and discussed.
coiling; covered stent; embolization; endovascular treatment; flow-diverting stent; visceral aneurysm
Venturini, Massimo; Piacentino, Filippo; Coppola, Andrea; Bettoni, Valeria; Macchi, Edoardo; De Marchi, Giuseppe; Curti, Marco; Ossola, Christian; Marra, Paolo; Palmisano, Anna; Cappelli, Alberta; Basile, Antonio; Golfieri, Rita; Cobelli, Francesco De; Piffaretti, Gabriele; Tozzi, Matteo; Carcano, Giulio; Fontana, Federico
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11383/2114086
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