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Surgical treatment of visceral artery aneurysms: A 25-year experience

Pulli, Raffaele, MD ; Dorigo, Walter, MD ; Troisi, Nicola, MD ; Pratesi, Giovanni, MD ; Innocenti, Alessandro Alessi, MD ; Pratesi, Carlo, MD

Journal of vascular surgery, 2008-08, Vol.48 (2), p.334-342 [Periódico revisado por pares]

New York, NY: Mosby, Inc

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Título:
Surgical treatment of visceral artery aneurysms: A 25-year experience
Autor: Pulli, Raffaele, MD ; Dorigo, Walter, MD ; Troisi, Nicola, MD ; Pratesi, Giovanni, MD ; Innocenti, Alessandro Alessi, MD ; Pratesi, Carlo, MD
Assuntos: Adult ; Aged ; Aneurysm - diagnostic imaging ; Aneurysm - mortality ; Aneurysm - surgery ; Angiography - methods ; Angioplasty - adverse effects ; Angioplasty - methods ; Biological and medical sciences ; Celiac Artery - diagnostic imaging ; Celiac Artery - surgery ; Cohort Studies ; Female ; Follow-Up Studies ; Gastroenterology. Liver. Pancreas. Abdomen ; Hepatic Artery - diagnostic imaging ; Hepatic Artery - surgery ; Humans ; Kaplan-Meier Estimate ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Male ; Medical sciences ; Mesenteric Artery, Superior - diagnostic imaging ; Mesenteric Artery, Superior - surgery ; Mesentery - blood supply ; Mesentery - physiopathology ; Mesentery - surgery ; Middle Aged ; Other diseases. Semiology ; Postoperative Complications - epidemiology ; Probability ; Renal Artery - diagnostic imaging ; Renal Artery - surgery ; Retrospective Studies ; Risk Assessment ; Severity of Illness Index ; Splanchnic Circulation ; Splenic Artery - diagnostic imaging ; Splenic Artery - surgery ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Survival Analysis ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome ; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels ; Vascular Surgical Procedures - adverse effects ; Vascular Surgical Procedures - methods
É parte de: Journal of vascular surgery, 2008-08, Vol.48 (2), p.334-342
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: Objective The aim of this study was to analyze our 25-year experience with surgical treatment of visceral artery aneurysms (VAAs), with particular attention paid to early and long-term results. Materials and Methods From January 1982 to September 2007, 55 patients (32 males, 58%, and 23 females, 42%) underwent surgical treatment of 59 VAAs. Only one patient was treated with an endovascular procedure. Mean patient age was 59.3 years (range, 36-78 years). The site of aneurysmal disease was splenic artery in 30 (50.8%) cases, renal artery in nine (15.2%) cases, common hepatic artery in seven (11.9%) cases, pancreaticoduodenal artery in four (6.8%) cases, celiac trunk in three (5.1%) cases, superior mesenteric artery in two (3.4%) cases, and gastroduodenal, inferior mesenteric, middle colic and right gastroepiploic in one (1.7%) case for each artery. Two (3.6%) patients had multiple VAAs. In five (9.1%) patients, an abdominal aortic aneurysm coexisted. Early results in terms of mortality and major complications were assessed. Follow-up consisted of clinical and ultrasound examinations at 1 and 12 months, and yearly thereafter. Long-term results in terms of survival and aneurysm-related complications were analyzed. Results In all but two cases, elective intervention in asymptomatic patients was performed. Two (3.6%) patients had a ruptured aneurysm (one pancreaticoduodenal artery and one middle colic artery). The one perioperative death was due to an acute pancreatitis in a patient operated on for a giant inflammatory splenic artery aneurysm, yielding a perioperative mortality rate of 1.8%. Two major complications (retroperitoneal hematoma and acute pancreatitis) were recorded. Mean duration of follow-up was 82.1 months (range, 0-324 months). Estimated 10-year survival rate was 79.5%. During follow-up two aneurysm-related complications occurred, with an estimated 10-year, aneurysm-related, complication-free survival rate of 75.2%. Conclusion In the era of minimally invasive therapeutic approaches, elective open surgical treatment of visceral artery aneurysms is safe and effective, and offers satisfactory early and long-term results.
Editor: New York, NY: Mosby, Inc
Idioma: Inglês

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Surgical treatment of visceral artery aneurysms: A 25-year experience

Pulli, Raffaele, MD ; Dorigo, Walter, MD ; Troisi, Nicola, MD ; Pratesi, Giovanni, MD ; Innocenti, Alessandro Alessi, MD ; Pratesi, Carlo, MD

New York, NY: Mosby, Inc

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