Visceral Artery aneurysms

The visceral arteries refer to the arteries that supply organs (viscera) in the abdomen and pelvis. These include the arteries suppling the liver, spleen, bowels and kidneys. If these arteries develop an abnormal dilatation or bulge, it is called a visceral artery aneurysm. This can refer to a kidney renal (kidney) artery aneurysm, hepatic (liver) artery aneurysm, splenic artery aneurysm, mesenteric (bowel) artery aneurysm, celiac artery aneurysm, superior mesenteric artery aneurysm, gastroduodenal artery aneurysm, or gastric (stomach) artery aneurysm.

Many visceral artery aneurysms are identified incidentally (without symptoms) on imaging such as CT scans, but not all require treatment or an operation. Small aneurysms only require monitoring with imaging (typically CT scan) and follow up consultation. Typically, if a visceral artery aneurysm is greater than 2 or 3 cm in size, an operation to seal off the aneurysm is recommended. The reason to treat the aneurysm is to prevent it from rupturing or bursting, and causing severe bleeding. The Interventional Radiologist (IR) will discuss this with you during consultation, and explain in detail the treatment options.

Pseudoaneurysm

There is a different type of abnormal dilatation or bulge of an artery called a pseudoaneurysm, where the wall is particularly thin and weak. These have a much higher risk of rupturing or bursting and require operative treatment in most cases regardless of size.

The treatment performed is an Interventional Radiology (IR) procedure, sometimes referred to as endovascular surgery. The aneurysm or pseudoaneurysm is treated from inside the artery, where coils and stents are typically deployed to seal the aneurysm, allowing it to heal and greatly decreasing the risk of rupture.

Effectiveness

• The success rate of endovascular treatment of a visceral artery aneurysm by Interventional Radiology (IR) is over 90%
• If successfully treated, the long-term survival rate is also over 90%
• There is a small chance (<10%) that the aneurysm may have a residual component or recanalise, in which case further treatment may be necessary

1. A specialist interventional radiologist will first consult and examine you. The doctor will discuss the treatment options with you and if appropriate, recommend that you undergo a procedure to treat the aneurysm
2. Most visceral aneurysm treatments are performed under sedation and local anaesthetic via a small catheter tube inserted into the femoral artery in your groin. In some cases access into an upper limb (arm) artery may be required.
3. The procedure typically takes between 1 and 2 hours
4. There may be a closure device or "stitch" used to seal the site where the catheter was inserted into the artery
5. You will be required to lie down and rest in bed for up to 4 hours post-operatively, which is to minimise bruising in the groin.
6. The procedure may be performed as a day-case or with an overnight hospital stay depending on complexity

The overall risk of complications is different depending on the location and size of the visceral artery aneurysm. Complications may include:

• Groin bruising or haematoma (bleeding lump)
• Damage to an artery resulting in decreased blood flow to the viscus (organ)
• Bleeding from the aneurysm due to rupture
• Embolisation or closure of an unintended artery

Interventional Radiologists (IRs) are specialty trained in the treatment of visceral artery aneurysms, including the pre-procedural assessment, operation and post-procedural care. Interventional Radiologists (IRs) are extensively experienced in angiography, embolisation and stenting procedures as they regularly perform angiography all throughout the body, including the aorta, upper limbs, lower limbs and visceral (organ) arteries.

If you would like to consult with an Interventional Radiologist about a visceral artery aneurysm, please send a referral for consultation, including the following

• Imaging results including ultrasound, CT, and other imaging
• Records of consultations with other doctors and specialists

Public eligible patients can undergo the treatment with no out-of-pocket expense in the public system.