Visceral Artery Aneurysms – An Indian Gastroenterologists Perspective

ABSTRACT:

Background and Aims: Visceral artery aneurysms (VAA) are a rare disease entity. Our study was designed to evaluate the etiology, presentation outcomes at 1 month in a tertiary care center for visceral artery aneurysms. Methods: We performed retrospective analysis of data from 2017-2021 at a tertiary care centre in Western India of all the patients with aneurysms. Results: Fifty-seven aneurysms and 48 pseudoaneurysms in 74 patients were studied. The most commonly involved vessels were splenic artery (69.5%) & gastroduodenal artery (GDA) (17.1%). About 75.6% patients were symptomatic, 51.3% had gastrointestinal bleeding (GI bleeding) & 24.3% abdominal pain. The most common etiologies noted were - Chronic Pancreatitis (35.1%) & decompensated cirrhosis (20.1%). Almost all patients with pseudoaneurysms were symptomatic (p< 0.0001). True aneurysms were more likely to be multiple. (p=0.009). There was no significant difference in mortality and rebleed at one month between aneurysms and pseudoaneurysms (p=0.4887 & p=0.873). Male patients were found to have a higher risk of GI bleeding, irrespective of etiology (p=0.006), whereas female patients were more likely to have complications post intervention (p=0.04). Conservative treatment was given to 32.4% of patients who had a mean size of aneurysm being 1.2­+0.77cm. Interventional radiology guided treatment was offered in the form of angiographic coiling (40.5%), glue injection (17.6%) and combined (5.4%). Around 8.1% patients had complications post intervention, most common being Gram negative septicemia; Conclusions: Pseudoaneurysms have a high risk of rupture,. Endovascular intervention in is safe and effective.