Individualized interventional treatment strategy selection and efficacy analysis for visceral artery aneurysms

Objective To analyze the interventional treatment and medium to long-term efficacy of visceral artery aneurysm（VAA），and to provide a reference for clinical selection of appropriate interventional treatment options.Methods A retrospective analysis was conducted on the clinical data of 67 VAA patients who underwent interventional treatment in Jiangsu Province Hospital of Chinese Medicine and General Hospital of Eastern Theater Command from January 2017 to October 2024. According to the anatomical characteristics and hemodynamic characteristics of the aneurysms，57 cases were treated with simple aneurysm sac embolization，4 cases with endovascular exclusion combined with aneurysm sac embolization，3 cases with simple bare stent implantation，and 3 cases with stent-assisted aneurysm sac embolization. Immediate post-operative angiography was performed，and the Raymond classification was used to evaluate the aneurysm sac occlusion. Digital subtraction angiography（DSA）or computed tomography angiography（CTA）reexamination was performed at the 6th and 12th months after the operation to observe changes in the size and closure of the aneurysm sac，patency of the parent artery and stent，and complications such as infarction of solid organs. Results A total of 76 VAAs were found in 67 patients，including 68 true aneurysms and 8 pseudoaneurysms. The aneurysm diameter was 1.2-5.6（2.19±0.75）cm. The total technical success rate of interventional treatment for all patients was 100%，68 aneurysms（89.5%）achieved Raymond class Ⅰ occlusion，8 aneurysms（10.5%）achieved class Ⅱocclusion，and there was no class Ⅲ occlusion case. The operation time was（49.7±21.4）min，and the hospitalization time was（4.0±3.0）days.Perioperative complications included post- embolization syndrome in 6 cases，splenic infarction in 3 cases，and pleural effusion in 1 case，all of which recovered after symptomatic treatment. The follow-up period after surgery was 12-84（32.4±16.7）months. There were no cases of aneurysm rupture，recurrence，enlargement，or treatment-related death during the follow-up，and the stent patency rate remained at 100%. Conclusion Interventional treatment for VAA is safe and effective，requiring individualized procedures based on aneurysm location，morphology，and hemodynamic characteristics.