Endovascular stent repair of celiac arterial aneurysm

Guidelines on the diagnosis, treatment and management of visceral and renal arteries aneurysms: a joint assessment by the Italian Societies of Vascular and Endovascular Surgery (SICVE) and Medical and Interventional Radiology (SIRM)

The objective of these Guidelines is to provide recommendations for the classification, indication, treatment and management of patients suffering from aneurysmal pathology of the visceral and renal arteries. The methodology applied was the GRADE-SIGN version, and followed the instructions of the AGREE quality of reporting checklist. Clinical questions, structured according to the PICO (Population, Intervention, Comparator, Outcome) model, were formulated, and systematic literature reviews were carried out according to them. Selected articles were evaluated through specific methodological checklists. Considered Judgments were compiled for each clinical question in which the characteristics of the body of available evidence were evaluated in order to establish recommendations. Overall, 79 clinical practice recommendations were proposed. Indications for treatment and therapeutic options were discussed for each arterial district, as well as follow-up and medical management, in both candidate patients for conservative therapy and patients who underwent treatment. The recommendations provided by these guidelines simplify and improve decision-making processes and diagnostic-therapeutic pathways of patients with visceral and renal arteries aneurysms. Their widespread use is recommended.

Surgical repair of a symptomatic celiac artery aneurysm with resection and end-to-end anastomosis

A true aneurysm of the celiac artery is a rare form of a visceral aneurysm, constituting ∼4% of visceral aneurysms. Mortality in ruptured cases is high; thus, early recognition and treatment are crucial. Recent guidelines suggest endovascular therapy; however, numerous complications are associated with endoluminal treatment. Open repair in select cases, using an individualized strategy fit for the patient's anatomy still provides excellent early and long-term results. Our patient was treated with open surgical resection and end-to-end anastomosis of the celiac and common hepatic arteries. A 43-month follow-up computed tomography angiogram revealed excellent hepatic artery patency and no pseudoaneurysm formation.

Endovascular treatment of a large saccular aneurysm of the celiac artery: a case report and review of literature

Celiac artery is a visceral abdominal vasculature whose aneurysms are very rare, accounting for less than 0.01% of all aneurysms. This condition can be treated by open aneurysmectomy or aneurysmorrhaphy and endovascular intervention. Due to the high mortality and morbidity associated with open surgery, endovascular intervention may be a better treatment option. Here, we present a case related to a 40-year-old man who had been experiencing vague epigastric pain for 4 months prior to admission and was managed endovascularly.

Endovascular treatment with stenting of celiac artery aneurysms

This study aimed to detail the clinical outcomes of patients suffering from celiac arterial aneurysm (CAA) that underwent treatment via stent occlusion.This is a single-center, retrospective study. A total of 8 consecutive CAA patients were treated via stent occlusion from March 2014 to September 2018 at our hospital. Follow-up computed tomography was conducted after stenting at 1, 3, 6, and 12-month time points and every year thereafter. Both short- and long-term outcomes were assessed.In total, 8 stents were inserted into these 8 patients, with 2 being uncovered and 6 being covered stents. In 2 patients, stents were positioned in the celiac artery, while in the remaining 6 patients they were placed in the celiac and common hepatic arteries. The median operative duration was 66 minutes. No patients exhibited procedure-associated complications, and the median follow-up duration was 39 months (range: 18-72). Abdominal contrast-enhanced CT analyses of these patients exhibited stent and distal artery patency in 100% of patients, together with CAA obliteration. Visceral necrosis did not occur in any patients over the follow-up period.Stent occlusion can be safely and effectively used to treat CAA patients.