Is surgical management of visceral artery aneurysms still relevant in the endovascular era?

Visceral artery aneurysms (VAAs) are rare vascular lesions with potentially life-threatening complications, particularly when rupture occurs. The role of open surgery in managing VAAs is evolving in the context of expanding endovascular therapies. To evaluate the clinical presentation, imaging features, surgical management strategies, and early outcomes of patients undergoing open surgical repair for VAAs at a tertiary referral center. A retrospective cross-sectional study was conducted, including adult patients treated for VAAs via open surgery between June 2021 and December 2024 at Viet Duc university hospital. Data collected included demographic characteristics, aneurysm location and morphology, surgical techniques, and perioperative outcomes. Nine patients underwent open surgery. Six had renal artery aneurysms, two had superior mesenteric artery aneurysms, and one had a common hepatic artery aneurysm. Renal aneurysms were mostly asymptomatic, with a mean diameter of 30.8 ± 8.78 mm. All patients underwent midline laparotomy. One hepatic aneurysm caused biliary obstruction and was treated with saphenous vein interposition graft. No perioperative mortality was observed. Two patients experienced self-limited postoperative complications. Open surgical repair remains a safe and effective option for patients with complex or symptomatic VAAs, particularly in settings where endovascular treatment is not feasible. Careful preoperative planning and tailored surgical techniques are essential to achieving good outcomes.