Visceral artery aneurysms, treatment and controversies: 20 years of single-center experience

Introduction/Aim. Visceral artery aneurysms (VAAs) are rare diseases most often diagnosed accidentally during diagnostic workups for other diseases or for abdominal pain of unknown etiology. The aim of this study was to present 20 years of single-center experience from the surgical treatment of VAAs. Methods. A retrospective study analyzed the outcomes of surgical treatment in 15 patients with VAAs, treated between 2004 and 2024. Both endovascular and classic, open surgical techniques were used, with special emphasis on the histopathological causes of aneurysm formation. Special attention is directed towards symptomatology, preoperative diagnostics, open and endovascular treatment techniques, as well as postoperative follow-up and possible secondary interventions. Results. The average age of patients was 56.1 years. There was a total of seven female and eight male patients. The average diameter of the aneurysms was 4.4 cm (ranging from 2.4 to 6 cm). Open surgical operations were performed in 12 patients, while 3 patients underwent endovascular reconstruction. Surgical treatment was per-formed on 10 patients due to aneurysm of the splenic artery, on 2 patients due to aneurysm of the gastroduodenal artery, on 1 patient due to aneurysm of the common hepatic artery, on 1 patient due to aneurysm of the celiac trunk, and on 1 patient due to aneurysm of the renal artery. Five patients were operated on as emergency cases due to aneurysm rupture and hemorrhagic shock, while the remaining patients were operated on electively. Immediately after surgery, death occurred in three patients, while in the others, the follow-up period lasted from two to ten years. Conclusion. VAAs represent a serious vascular disease, which, if not diagnosed and treated in time, can lead to deadly complications due to aneurysm rupture and bleeding. In the era of endovascular surgery, open surgical reconstruction of visceral aneurysms continues to play an important role.