IYSC15 - Endovascular treatment of visceral artery aneurysm. Late results from the Italian Collaborators for EVAR (ICE) multicenter registry

Thursday, June 5, 2025

2:40 PM – 2:45 PM CT

Location: Morial CC, Second Floor, Room 224

Submitting & Presenting Author(s)

Sergio Zacà, MD (he/him/his)

Vascular Surgeon
Department of Precision and Regenerative Medicine and Jonic Area (DiMePre-J), Vascular and Endovascular Surgery, University of Bari School of Medicine “Aldo Moro”, Bari, Italy
Bari, Puglia, Italy

Slides

Co-Author(s)

Lucia Di Stefano, MD

Vascular Surgeon
Department of Precision and Regenerative Medicine and Jonic Area (DiMePre-J), Vascular and Endovascular Surgery, University of Bari School of Medicine “Aldo Moro”, Bari, Italy
Bari, Puglia, Italy
Davide Esposito, MD (he/him/his)

MD, Vascular Surgeon
IRCCS San Martino – University of Genova, Italy
Genoa, Liguria, Italy
Gaddiel Mozzetta, MD (he/him/his)

Research fellow
Ospedale Policlinico San Martino
Genova, Liguria, Italy
SS

Sara Speziali

Vascular Surgeon
University of Florence
Florence, Italy
GP

Giovanni Pratesi

University of Genoa, Ospedale Policlinico San Martino, Italy
Walter Dorigo, MD

Associate Professor in Vascular Surgery
University of Florence
Firenze, Toscana, Italy
RP

Raffaele Pulli

Full Professor in Vascular Surgery
University of Florence
Florence, Italy
Gabriele Piffaretti, MD, PhD (he/him/his)

Associate Professor of Vascular Surgery
Vascular Surgery - Department of Medicine and Surgery, University of Insubria Faculty of Medicine and Surgery
Varese, Lombardia, Italy
DA

Domenico Angiletta

Professor of Vascular Surgery
Department of Precision and Regenerative Medicine and Jonic Area (DiMePre-J), Vascular and Endovascular Surgery, University of Bari School of Medicine “Aldo Moro”, Bari, Italy
Bari, Italy

Objectives: Endovascular treatment of visceral artery aneurysm (VAA) represents a minimally-invasive treatment option and an alternative solution at open surgery. The study aimed to analyze the long-term results of a multicenter cohort treated for VAA through endovascular strategies in terms of safety, effectiveness and durability.

Methods: A retrospective review was conducted on all the patients treated between January 2014 and January 2024 in the participating centers (Florence, Genoa, Varese and Bari). The included cases were affected by VAAs involving the celiac and superior mesenteric artery and its branches. Also VAAs involving the renals were included. Demographics, baseline characteristics and intra/post-operative data were collected. Endovascular techniques included reconstructive (BMS, flow-diverting and covered stent) and occlusive (plug, coils) options. Early outcomes included: intervention-related mortality and reintervention during a 30-day period. Late outcomes included: 5-year freedom from aneurysm-related mortality (ff-ARM), sac-expansion (ff-SE) and open/endo reintervention (ff-R). 5-year primary patency (PP) was analyzed only for reconstructive techniques.

Results: A total of 144 VAAs (9 in urgent setting, 7.9%) were treated in 109 patients (65 males, 57%). Mean age was 63.1±14.2 years. The main visceral site was the splenic artery (60/114, 52.6%) and the coils embolization was used in 54.4% of the cases (62/114). Adjunctive unplanned procedures was performed in 12.3% and technical success was obtained in 95.6% and no open surgical conversions were recorded. Surgical complications was observed in 3.5%. No intervention-related deaths were recorded and 3 cases underwent early reintervention (early reintervention rate 2.6%). The 5-year estimated ff-ARM was 100%, ff-SE 94.1%, ff-R 32.4% and PP was 85.8%.

Conclusions: In our experience, the endovascular treatment of VVAs showed promising profiles of safety with satisfactory results in terms of effectiveness and durability.