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KEY FACTS
Terminology
Preprocedure
Procedure
Outcomes
TERMINOLOGY
Definitions
- Visceral artery aneurysms: Relatively infrequent
- Incidence of 0.1-2.0% in general population
- Reported rupture rates of 20-70%
- 50% present with rupture
- 8.5-75.0% mortality rate (location dependent)
- Reported rupture rates of 20-70%
- Various etiologies
- Atherosclerosis (most common)
- Infection (mycotic)
- Trauma
- Genetic
- Marfan syndrome
- Klippel-Trenaunay-Weber syndrome
- Ehlers-Danlos syndrome
- Behçet syndrome
- Vasculitis
- Iatrogenic intervention
- Visceral artery aneurysm distribution
- Splenic artery: 60-80%
- Hepatic artery: 20%
- Superior mesenteric artery (SMA): 5%
- Gastroduodenal/gastroepiploic artery: 4%
- True aneurysm: Contains all 3 layers of arterial wall
- Degenerative process involving arterial wall
- Rupture risk increases when size ≥ 2 cm
- Pseudoaneurysm (false aneurysm): Arterial wall disruption with focal contained hemorrhage
- Does not contain all 3 layers of arterial wall
- Typically associated perivascular inflammation
- Etiologies include trauma, infection, vasculitis
- High risk of rupture
- Usually require treatment, regardless of size
- Increasing incidence from iatrogenic injury
- Endoscopic/percutaneous biliary interventions
- Laparoscopic interventions
- Transarterial chemo-/radioembolization
- Transplantation related
- Incidence of 0.1-2.0% in general population
- Fibromuscular dysplasia (FMD): Noninflammatory arteriopathy typified by abnormal cellular growth in walls of medium to large arteries
- Segmental arterial mediolysis (SAM): Nonatherosclerotic, noninflammatory arteriopathy
- Histology shows vacuolar degeneration of smooth muscle in outer media of arterial wall
- Clinical symptoms include acute abdominal pain and hemorrhage in late middle-aged and older patients
- Responds poorly to angioplasty and other interventions
- Visceral artery aneurysms: Relatively infrequent
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Patient Position/Location
Procedure Steps
Alternative Procedures/Therapies
POST PROCEDURE
Things to Do
OUTCOMES
Complications
Expected Outcomes
Selected References
- Habash M et al: Splenic artery embolization for patients with high-grade splenic trauma: indications, techniques, and clinical outcomes. Semin Intervent Radiol. 38(1):105-12, 2021
- Obara H et al: Current management strategies for visceral artery aneurysms: an overview. Surg Today. 50(1):38-49, 2020
- Gornik HL et al: First international consensus on the diagnosis and management of fibromuscular dysplasia. J Hypertens. 37(2):229-52, 2019
- Vandy FC et al: Pancreaticoduodenal and gastroduodenal artery aneurysms associated with celiac artery occlusion. Ann Vasc Surg. 41:32-40, 2017
- Kok HK et al: Systematic review and single-center experience for endovascular management of visceral and renal artery aneurysms. J Vasc Interv Radiol. 27(11):1630-41, 2016
- Pillai AK et al: Segmental arterial mediolysis. Cardiovasc Intervent Radiol. 37(3):604-12, 2014
- Balderi A et al: Endovascular treatment of visceral artery aneurysms and pseudoaneurysms: our experience. Radiol Med. 117(5):815-30, 2012
- Spiliopoulos S et al: Endovascular treatment of visceral aneurysms and pseudoaneurysms: long-term outcomes from a multicenter European study. Cardiovasc Intervent Radiol. 35(6):1315-25, 2012
- Etezadi V et al: Endovascular treatment of visceral and renal artery aneurysms. J Vasc Interv Radiol. 22(9):1246-53, 2011
- Gehlen JM et al: Visceral artery aneurysms. Vasc Endovascular Surg. 45(8):681-7, 2011
- Saba L et al: The multidetector computed tomography angiography (MDCTA) in the diagnosis of splenic artery aneurysm and pseudoaneurysm. Acta Radiol. 52(5):488-98, 2011
- Takao H et al: Natural history of true pancreaticoduodenal artery aneurysms. Br J Radiol. 83(993):744-6, 2010
- Chao CP: Segmental arterial mediolysis. Semin Intervent Radiol. 26(3):224-32, 2009
- Michael M et al: Segmental arterial mediolysis: CTA findings at presentation and follow-up. AJR Am J Roentgenol. 187(6):1463-9, 2006
- Nosher JL et al: Visceral and renal artery aneurysms: a pictorial essay on endovascular therapy. Radiographics. 26(6):1687-704; quiz 1687, 2006
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Preprocedure
Procedure
Outcomes
TERMINOLOGY
Definitions
- Visceral artery aneurysms: Relatively infrequent
- Incidence of 0.1-2.0% in general population
- Reported rupture rates of 20-70%
- 50% present with rupture
- 8.5-75.0% mortality rate (location dependent)
- Reported rupture rates of 20-70%
- Various etiologies
- Atherosclerosis (most common)
- Infection (mycotic)
- Trauma
- Genetic
- Marfan syndrome
- Klippel-Trenaunay-Weber syndrome
- Ehlers-Danlos syndrome
- Behçet syndrome
- Vasculitis
- Iatrogenic intervention
- Visceral artery aneurysm distribution
- Splenic artery: 60-80%
- Hepatic artery: 20%
- Superior mesenteric artery (SMA): 5%
- Gastroduodenal/gastroepiploic artery: 4%
- True aneurysm: Contains all 3 layers of arterial wall
- Degenerative process involving arterial wall
- Rupture risk increases when size ≥ 2 cm
- Pseudoaneurysm (false aneurysm): Arterial wall disruption with focal contained hemorrhage
- Does not contain all 3 layers of arterial wall
- Typically associated perivascular inflammation
- Etiologies include trauma, infection, vasculitis
- High risk of rupture
- Usually require treatment, regardless of size
- Increasing incidence from iatrogenic injury
- Endoscopic/percutaneous biliary interventions
- Laparoscopic interventions
- Transarterial chemo-/radioembolization
- Transplantation related
- Incidence of 0.1-2.0% in general population
- Fibromuscular dysplasia (FMD): Noninflammatory arteriopathy typified by abnormal cellular growth in walls of medium to large arteries
- Segmental arterial mediolysis (SAM): Nonatherosclerotic, noninflammatory arteriopathy
- Histology shows vacuolar degeneration of smooth muscle in outer media of arterial wall
- Clinical symptoms include acute abdominal pain and hemorrhage in late middle-aged and older patients
- Responds poorly to angioplasty and other interventions
- Visceral artery aneurysms: Relatively infrequent
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Patient Position/Location
Procedure Steps
Alternative Procedures/Therapies
POST PROCEDURE
Things to Do
OUTCOMES
Complications
Expected Outcomes
Selected References
- Habash M et al: Splenic artery embolization for patients with high-grade splenic trauma: indications, techniques, and clinical outcomes. Semin Intervent Radiol. 38(1):105-12, 2021
- Obara H et al: Current management strategies for visceral artery aneurysms: an overview. Surg Today. 50(1):38-49, 2020
- Gornik HL et al: First international consensus on the diagnosis and management of fibromuscular dysplasia. J Hypertens. 37(2):229-52, 2019
- Vandy FC et al: Pancreaticoduodenal and gastroduodenal artery aneurysms associated with celiac artery occlusion. Ann Vasc Surg. 41:32-40, 2017
- Kok HK et al: Systematic review and single-center experience for endovascular management of visceral and renal artery aneurysms. J Vasc Interv Radiol. 27(11):1630-41, 2016
- Pillai AK et al: Segmental arterial mediolysis. Cardiovasc Intervent Radiol. 37(3):604-12, 2014
- Balderi A et al: Endovascular treatment of visceral artery aneurysms and pseudoaneurysms: our experience. Radiol Med. 117(5):815-30, 2012
- Spiliopoulos S et al: Endovascular treatment of visceral aneurysms and pseudoaneurysms: long-term outcomes from a multicenter European study. Cardiovasc Intervent Radiol. 35(6):1315-25, 2012
- Etezadi V et al: Endovascular treatment of visceral and renal artery aneurysms. J Vasc Interv Radiol. 22(9):1246-53, 2011
- Gehlen JM et al: Visceral artery aneurysms. Vasc Endovascular Surg. 45(8):681-7, 2011
- Saba L et al: The multidetector computed tomography angiography (MDCTA) in the diagnosis of splenic artery aneurysm and pseudoaneurysm. Acta Radiol. 52(5):488-98, 2011
- Takao H et al: Natural history of true pancreaticoduodenal artery aneurysms. Br J Radiol. 83(993):744-6, 2010
- Chao CP: Segmental arterial mediolysis. Semin Intervent Radiol. 26(3):224-32, 2009
- Michael M et al: Segmental arterial mediolysis: CTA findings at presentation and follow-up. AJR Am J Roentgenol. 187(6):1463-9, 2006
- Nosher JL et al: Visceral and renal artery aneurysms: a pictorial essay on endovascular therapy. Radiographics. 26(6):1687-704; quiz 1687, 2006
