• Massimo Venturini, Paolo Marra, Michele Colombo, Marta Panzeri, Simone Gusmini, Claudio Sallemi, Marco Salvioni, Carolina Lanza, Giulia Agostini, Gianpaolo Balzano, Yamume Tshomba, Germano Melissano, Massimo Falconi, Roberto Chiesa, Francesco De Cobelli, and Alessandro Del Maschio.
• Department of Radiology, San Raffaele Scientific Institute, Vita Salute University, Via Olgettina, 60, 20132, Milan, Italy. venturini.massimo@hsr.it.
• Cardiovasc Intervent Radiol. 2018 Mar 1; 41 (3): 385-397.

PurposeEndovascular repair of true visceral artery aneurysms (VAAs) and pseudoaneurysms (VAPAs) with stent-grafting (SG) can simultaneously allow aneurysm exclusion and vessel preservation, minimizing the risk of ischemic complications. Our aim was to report a single-center experience on SG of visceral aneurysms, focusing on technical aspects, clinical outcome and mid-term patency.Materials And MethodsConsecutive patients affected by VAAs-VAPAs and submitted to endovascular treatment were retrospectively reviewed, and SG cases with the self-expandable peripheral Viabahn stent-graft were analyzed (2003-2017). Aneurysm type, patient number, SG clinical setting, procedural data, peri-procedural complications, technical success, 30-day clinical success, 30-day mortality and follow-up period (aneurysm exclusion, stent-graft patency, ischemic complications) were analyzed.ResultsSG was performed in 40 patients (24 VAPAs/16 VAAs) and in 44 procedures (25 in emergency, 19 in elective treatments), via transfemoral in 37 cases (transaxillary in 7 cases). One peri-procedural complication was recorded (a splenic artery dissection successfully converted to transcatheter embolization). The overall technical and clinical success rates were, respectively, 96 and 84%, with excellent trend in elective treatments (both 100%). Overall 30-day mortality was 12.5% (septic shock after pancreatic surgery). Stent-graft thrombosis occurred in 2 patients within 3 months, with aneurysm exclusion and without ischemic complications. Stent-graft patency and aneurysm exclusion were confirmed at 6, 12 and 36 months in 18, 12 and 7 patients, respectively.ConclusionSG of VAAs and VAPAs was safe and effective, particularly in elective treatments. The Viabahn stent-graft, flexible and without shape memory, is suitable for endovascular repair of tortuous visceral arteries.

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