Visceral Artery Aneurysms Embolization and Other Interventional Options: State of the Art and New Perspectives
Massimo Venturini, Filippo Piacentino, Andrea Coppola, Valeria Bettoni, Edoardo Macchi, Giuseppe De Marchi, Marco Curti, Christian Ossola, Paolo Marra, Anna Palmisano, Alberta Cappelli, Antonio Basile, Rita Golfieri, Francesco De Cobelli, Gabriele Piffaretti, Matteo Tozzi, Giulio Carcano, Federico Fontana
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.