Kalko Yusuf, Ugurlucan Murat, Basaran Murat, Kafali Eylul, Aydin Unal, Kafa Ulku, Kosker Taylan, Ozcaliskan Ozerdem, Yilmaz Erdal, Alpagut Ufuk, Yasar Tahsin, Dayioglu Enver
Cardiovascular Surgery Service, Bezm-I Alem Vakif Gureba Hospital, Istanbul, Turkey.
Heart Surg Forum. 2007;10(1):E24-9. doi: 10.1532/HSF98.20061130.
Visceral artery aneurysms are rare vascular malformations and the literature lacks satisfactory general information about the pathology. The aim of this study was to review our experiences in the diagnosis and treatment of visceral artery aneurysms.
We retrospectively reviewed data on 10 patients who were diagnosed with visceral artery aneurysms at our institution between June 2002 and September 2005. All available clinical, pathologic, and postoperative data were reviewed and analyzed for postoperative outcome.
Four splenic artery aneurysms, 2 hepatic artery aneurysms, 5 renal artery aneurysms, 1 superior mesenteric artery aneurysm, and 1 inferior mesenteric artery aneurysm (13 total visceral artery aneurysms) were diagnosed in 10 patients. All the patients were treated except 1 patient with bilateral renal artery aneurysms. One patient required emergent surgical treatment due to splenic artery aneurysm rupture. Only 1 patient underwent endovascular treatment (ie, coil embolization for a superior mesenteric artery aneurysm); otherwise all the patients were treated surgically on an elective basis. Surgical treatment modalities included ligation with exclusion in 4 patients (2 splenic artery aneurysms, 1 renal artery aneurysm, 1 hepatic artery aneurysm) and resection with revascularization in 4 patients (1 splenic artery aneurysm, 2 renal artery aneurysms, 1 hepatic artery aneurysm, 1 inferior mesenteric artery aneurysm). Histopathologic examination of the vascular materials revealed major atherosclerotic changes except one that showed inflammatory vasculitic changes. One patient required bleeding revision, and mortality did not occur in any of the patients.
Visceral artery aneurysms are rare and potentially life-threatening vascular disorders. The number of cases diagnosed every year increases because of advanced radiologic diagnostic methods and screening programs. Careful consideration and early management of these malformations can be life saving.
内脏动脉瘤是罕见的血管畸形，文献中缺乏关于其病理的令人满意的综合信息。本研究的目的是回顾我们在内脏动脉瘤诊断和治疗方面的经验。
我们回顾性分析了2002年6月至2005年9月期间在我院诊断为内脏动脉瘤的10例患者的数据。对所有可用的临床、病理和术后数据进行回顾并分析术后结果。
10例患者中诊断出4例脾动脉瘤、2例肝动脉瘤、5例肾动脉瘤、1例肠系膜上动脉瘤和1例肠系膜下动脉瘤（共13个内脏动脉瘤）。除1例双侧肾动脉瘤患者外，所有患者均接受了治疗。1例患者因脾动脉瘤破裂需要紧急手术治疗。仅1例患者接受了血管内治疗（即对肠系膜上动脉瘤进行弹簧圈栓塞）；否则所有患者均接受择期手术治疗。手术治疗方式包括4例患者采用结扎加旷置术（2例脾动脉瘤、1例肾动脉瘤、1例肝动脉瘤）和4例患者采用切除加血管重建术（1例脾动脉瘤、2例肾动脉瘤、1例肝动脉瘤、1例肠系膜下动脉瘤）。对血管材料的组织病理学检查显示，除1例显示炎症性血管炎改变外，主要为动脉粥样硬化改变。1例患者需要进行出血修正，所有患者均未发生死亡。
内脏动脉瘤是罕见且可能危及生命的血管疾病。由于先进的放射学诊断方法和筛查项目，每年诊断出的病例数有所增加。对这些畸形进行仔细考虑和早期处理可挽救生命。
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