Clinical review demonstrates endovascular techniques for visceral and renal artery aneurysms, suggesting viable alternatives for high-risk surgical candidates.
Visceral artery aneurysms (VAAs), which were once considered uncommon, are now being diagnosed with increasing frequency, a fact that reflects the routine use of computed tomography (CT), magnetic resonance imaging, and ultrasonography. Diagnostic radiology plays a major role in the detection and characterization of VAAs. Cross-sectional imaging can help exclude aneurysm rupture, which requires emergent treatment. CT angiography or catheter angiography can clearly depict the aneurysm and help identify other aortic, visceral, or peripheral aneurysms. Most important, radiologic examination can help determine the adequacy of the collateral blood supply to the vascular bed distal to the aneurysm, information that is essential prior to the initiation of endovascular treatment. Advances in endovascular therapy have allowed interventional radiologists to contribute to the management of VAAs. Coil embolization or covered stent placement can now be used to treat patients with aneurysms whose size or location would make a surgical approach problematic, as well as patients in whom surgery is considered to pose considerable risk.
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Nosher et al. (2006) studied this question.
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