Ferrero E, Gaggiano A, Ferri M, Viazzo A, Berardi G, Piazza S, Cumbo P, Lamorgese V, Nessi F
Vascular and Endovascular Surgery Unit, Mauriziano Umberto I Hospital, Turin, Italy.
Int Angiol. 2010 Feb;29(1):30-6.
The aim of this study is to evaluate early and long term results obtained with a retrospective review in 8-year experience with surgical/endovascular treatment of visceral artery aneurysm (VAA) in a single center.
Between 2001 and 2008 in our vascular surgery unit visceral artery aneurysms were diagnosed with CT and/or angiography in 17 patients (9 male), mean age 66 years old (range: 18 to 78). All patients underwent surgical or endovascular treatment of splanchnic artery aneurysm. In 14 patients the localization was single, in 3 it was multiple. The arteries involved were: splenic artery 53%, superior mesenteric artery 17.7%, pancreaticoduodenal artery 17.7%, celiac axis 5.8% and hepatic artery 5.8%. The 29.4% of the patients presented with aneurysm rupture. Coil embolizzation was used in 11.6% of the cases while surgery was used in 88.4% of the cases.
Total survival rate was 94.2%, the survival rate in emergency cases was 80% while it was 100% in elective cases. Follow-up revealed excellent results after an average of 46 months (range: 8-102).
The worst prognosis for ruptured cases associated with the good result of the surgical/endovascular treatment in elective cases, suggests active interaction for such pathologies; in emergency cases the mortality incidence is too high. Today endovascular treatment presents lower morbidity and mortality rates and shorter hospitalization, but surgery is still a good therapeutic option for the treatment of the VAA, in subjects with low surgical risk, determining a definitive and long-lasting correction of the aneurysmal pathology and guaranteeing the correct perfusion of the organs, by grafts; moreover many aneurysms are not suitable for endovascular treatment.
本研究旨在通过对单中心8年内脏动脉动脉瘤（VAA）手术/血管内治疗经验的回顾性分析，评估其早期和长期疗效。
2001年至2008年期间，我们血管外科共诊断出17例（9例男性）内脏动脉动脉瘤患者，平均年龄66岁（范围：18至78岁）。所有患者均接受了内脏动脉动脉瘤的手术或血管内治疗。14例患者为单发，3例为多发。受累动脉包括：脾动脉53%，肠系膜上动脉17.7%，胰十二指肠动脉17.7%，腹腔干5.8%，肝动脉5.8%。29.4%的患者出现动脉瘤破裂。11.6%的病例采用弹簧圈栓塞，88.4%的病例采用手术治疗。
总生存率为94.2%，急诊病例生存率为80%，择期病例生存率为100%。随访显示，平均46个月（范围：8至102个月）后效果良好。
破裂病例预后较差，而择期病例手术/血管内治疗效果良好，提示对此类疾病应积极干预；急诊病例死亡率过高。目前血管内治疗的发病率和死亡率较低，住院时间较短，但对于手术风险低的VAA患者，手术仍是一种良好的治疗选择，可通过移植物对动脉瘤病变进行确定性和持久的矫正，并保证器官的正确灌注；此外，许多动脉瘤不适合血管内治疗。
