Prestige plus coils in the treatment of visceral artery aneurysms: a safe and effective tool even in challenging anatomy

BACKGROUND: Visceral artery aneurysm (VAA) is a ballooning of a portion of the splenic, renal, hepatic or mesenteric arteries. Although there are various options for treating VAAs, recently, coil embolization has become the most commonly used procedure. However, the endovascular technique remains challenging and not considered as suitable option in patients with tortuous arterial anatomy.METHODS: We report five cases of visceral aneurysms in adult patients presenting with challenging anatomies, all treated with embolization through the Prestige Coil System (Balt, Montmorency, France).RESULTS: In our clinical practice, the Prestige Coil System overcomes the limitations of the traditional endovascular devices, above all, the recanalization of the target aneurismatic vessels. The absence of fibers allows the coils to be softer than fibered coils, achieving a high packing density within the target vascular space, preventing recanalization. Another limitation overcome by the use of Prestige Plus coils is the lower tendency to cause ischemia of the target organ, thanks to their structural features.CONCLUSIONS: Our preliminary observations prove Prestige Coil System to be a reliable, safe and effective tool for endovascular embolization treatment even in cases of tortuous anatomy and challenging VAA exclusion.