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Special Issue "Recent Advances on the Treatment of Visceral Aneurysm"

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Special Issue Editors

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Guest Editor

1. Associate Professor of Vascular Surgery, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy
2. Chief of Department of Vascular Surgery, Gruppo Policlinico di Monza, Monza, Italy
Interests: vascular surgery; endovascular surgery; aneurysm treatment; visceral arteries

Prof. Dr. Giovanni Pratesi

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Guest Editor

1. Full Professor of Vascular Surgery, Department of Integrated Surgical and Diagnostic Sciences, University of Genoa, Italy
2. Director of the Clinic of Vascular Surgery, Hospital S. Martino, Genoa, Italy
Interests: vascular surgery; endovascular surgery; aneurysm treatment; visceral arteries

Dr. Luigi Federico Rinaldi

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Guest Editor

1. Vascular Surgery, Department of Integrated Surgical and Diagnostic Sciences, University of Genoa, Genoa, Italy
2. Vascular Surgery, Ospedale Policlinico di Monza, Monza, Italy
Interests: vascular surgery; endovascular surgery; aneurysm treatment; visceral arteries

Special Issue Information

Dear Colleagues,

Although rare, visceral aneurysms represent a major challenge in vascular surgery, due to the associated morbidity/mortality and the difficult therapeutic choices. The most debated issues about the management of visceral artery aneurysms regard the indications and the optimal kind of treatment.

The guidelines followed in Europe and the US currently disagree on many aspects of this matter: on one hand, the traditional view sees visceral aneurysms as a single entity and bases the indication to surgery mainly on their size and the patient’s condition; on the other hand, the most recent SVS Guidelines (2020) started differentiating the aneurysms according to their location and the specific rupture risk of each visceral vessel.

The development of endovascular devices and the introduction of innovative and less invasive techniques (flow diverters, coils/microcoils or glue embolization, and robotic surgery) are multiplying the therapeutic possibilities, but they also require a deep knowledge of the risks and benefits of each technique and the correct selection of cases in order to achieve the best results.

The aim of this Special Issue is to depict the state of the art in terms of therapeutic options for visceral aneurysms, with a special focus on the most recent innovations and future perspectives in this field.

Dr. Enrico Maria Marone
Prof. Dr. Giovanni Pratesi
Dr. Luigi Federico Rinaldi
Guest Editors

Manuscript Submission Information

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Keywords

visceral aneurysms
vascular surgery
endovascular treatment
lparoscopic surgery
robotic surgery
embolization
flow-diverting stents
covered stents

Published Papers (2 papers)

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Research

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Open AccessArticle

Can Color Doppler Ultrasound Be Effectively Used as the Follow-Up Modality in Patients Undergoing Splenic Artery Aneurysm Embolization? A Correlational Study between Doppler Ultrasound, Magnetic Resonance Angiography and Digital Subtraction Angiography

Krzysztof Lamparski

Grzegorz Procyk

Krzysztof Bartnik

Krzysztof Korzeniowski

Magdalena Januszewicz

and

J. Clin. Med. 2023, 12(3), 792; https://doi.org/10.3390/jcm12030792 - 19 Jan 2023

Viewed by 481

Abstract

Splenic artery aneurysm (SAAs) rupture is associated with a high mortality rate. Regular surveillance with imaging before and after intervention is crucial to guide best evidence treatment. The following study aimed to determine the efficacy of color Doppler ultrasound imaging (DUS) compared to digital subtraction angiography (DSA) and magnetic resonance angiography (MRA) as a follow-up modality after selective coil embolization of true SAAs. We analyzed data from 20 patients, 15 females (48.1 ± 16.1 years) undergoing selective SAA coil embolization using detachable fibered embolization coils. Imaging using DUS, MRA, and DSA was performed 3 months after the initial embolization or the consequent re-embolization procedure. Primary clinical success, defined as Class I aneurysm occlusion, on 3-month follow-up was seen in 16 (80.0%) patients. DUS had a sensitivity of 94.4% and a specificity of 42.9% when compared to DSA and 92.3% and 30%, respectively, when compared to MRA in identifying Class I aneurysm occlusion. The positive predictive value (PPV) of DUS in identifying the need for re-embolization was 75.0%, while the NPV of DUS in these terms was 90.5%. DUS showed a high sensitivity in detecting aneurysm occlusion and clinical success, simultaneously exhibiting poor specificity. Still, with caution, this follow-up modality could be used for monitoring select low-risk patients after selective embolization of SAAs. DUS could provide a higher cost-to-benefit ratio, enabling more systematic post-procedural follow-up, as it is far more commonly used compared to MRA and non-invasive compared to DSA. Full article

(This article belongs to the Special Issue Recent Advances on the Treatment of Visceral Aneurysm)

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Other

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Open AccessCase Report

Endovascular Management of Vascular Complications in Ehlers–Danlos Syndrome Type IV

Pierre Antoine Barral

and

J. Clin. Med. 2022, 11(21), 6344; https://doi.org/10.3390/jcm11216344 - 27 Oct 2022

Viewed by 605

Abstract

(1) Background: The vascular type of Ehlers–Danlos syndrome (vEDS) is a rare genetic connective tissue disorder caused by pathogenic variants in the COL3A1 gene that result in arterial and organ fragility and premature death. We present five cases of vEDS that highlight the diagnosis and treatment challenges encountered by clinicians with these patients. (2) Case presentations: we present the cases of five patients with vascular complications of vEDS who were successfully managed using endovascular interventions or hybrid techniques at our institution from 2005 to 2022. (3) Conclusions: These data emphasize that a multidisciplinary approach is needed for vEDS patients and that when endovascular or hybrid treatment is performed in a timely manner by a skilled team of interventional radiologists, good results can be achieved. Our report also demonstrates that the prognosis of vEDS patients has improved over the past 20 years with a new prevention program including celiprolol therapy, physical activity adaptation and limitation, and scheduled monitoring by expert clinicians. Full article

(This article belongs to the Special Issue Recent Advances on the Treatment of Visceral Aneurysm)

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