Interventional Management of Visceral Artery Aneurysms: Simple to Complex

Abstract Visceral artery aneurysms (VAAs) are uncommon but potentially life-threatening vascular disorders that can involve the celiac, superior, and inferior mesenteric arteries or their branches. They are often asymptomatic but can present with vague abdominal pain, secondary effects, or signs of hemorrhage. The most common site of involvement is the splenic artery, followed by the hepatic artery, the celiac axis, and mesenteric arterial branches. VAAs can be classified into two types: true aneurysms (TAs) and pseudoaneurysms (PSAs). Imaging, particularly multidetector computed tomography angiography, is the cornerstone in diagnosing VAAs. Treatment decisions are based on the risk of rupture and clinical deterioration in a patient with a VAA. The endovascular approach remains the mainstay in the treatment of VAAs. As a general guideline, PSAs, even when asymptomatic, should always be treated. TAs are treated based on their size and location. Deconstructive and reconstructive strategies are the standard treatment options for any VAA, and assessing the vascular anatomy and collateral circulation is paramount for treatment decisions.