Endovascular treatment of aneurysms and pseudoaneurysms of visceral arteries

Ter-Akopyan A.V., Abramov A.S., Nikitin N.E., Kalinin A.A., Kryuchkova O.V.

Central Clinical Hospital and Polyclinic of the RF President’s Affairs Administration, Moscow, Russia

Objective. The purpose of the study was to demonstrate the possibilities and efficacy of endovascular interventions in patients with visceral artery aneurysms.

Patients and methods. From 2013 to June 2020, we performed 15 embolizations of visceral artery aneurysms in 15 patients (8 men and 7 women). The technical success rate was 100%. The patients’ age varied from 32 to 71 years. In 8 cases, the aneurysm was located in the basin of the splenic artery, in 3 cases in the gastroduodenal artery, in 2 cases in the superior mesenteric artery and in 2 cases in the renal artery. Three aneurysms were classified as false, and 12 as true. All aneurysms were saccular, with their diameter ranging from 6 to 32 mm. In 2 patients aneurysms were detected after endured infective endocarditis, in 8 during examination in abdominal pain syndrome, and in 5 cases as an incidental finding while performing computed tomography of abdominal organs. One patient was subjected to embolization of the afferent vessel, two underwent implantation of stent grafts into the aneurysmal neck area, and eleven underwent aneurysmal sac embolization with microcoils. In 9 cases, embolization was performed using microcoils only in 1 case using microcoils with balloon assistance, and in 2 cases using microcoils with stent assistance. We used from 1 to 12 microcoils, with a diameter of from 2 to 30 mm.

Results. During endovascular embolization of visceral artery aneurysms there were no target-organ infarctions, haemorrhagic complications, nor lethal outcomes. In the early postoperative period, 7 patients developed pain syndrome. In 1 case pain syndrome was relieved by narcotic analgesics, in 4 cases by spasmolytics, and in 2 cases by a combination of spasmolytics and non-narcotic analgesics.

Conclusions. Endovascular treatment of visceral arterial aneurysms is an efficient and safe method.

KEY WORDS: echocardiography, length velocity, myocardial motion velocity, intraventricular blood flows, myocardial revascularization.

Р. 40

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