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

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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.

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