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Hépato-Gastro & Oncologie Digestive

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Diagnosis and treatment of visceral artery aneurysms Volume 22, issue 9, Novembre 2015

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Authors
1 Hôpital Beaujon,
service de chirurgie hépatobiliaire et transplantation hépatique,
100 Boulevard du Général Leclerc,
92110 Clichy, France
2 Hôpital Cochin,
service de radiologie,
Paris, France
3 Hôpital Beaujon,
service de radiologie,
Clichy, Paris, France
4 Hôpital Cochin,
service de chirurgie digestive,
hépato-bilio-pancréatique et endocrine,
Paris
5 Institut Mutualiste Montsouris,
Département de pathologie digestive,
75014, Paris, France
6 Faculté de Médecine Paris Descartes,
Université Paris Descartes,
Paris, France
* Tirés à part

Visceral artery aneurysms (VAA), are uncommon lesions with a risk for rupture that can be life threatening. Thanks to frequent use of imaging techniques and especially enhanced computed tomography, a number of VAA are discovered incidentally during assessment for abdominal pain or other disorders. Arteriography can be useful to confirm diagnosis, to determine the exact location of the aneurysm, to screen for other lesions, and to assess the possibility of endovascular treatment. Treatment should be proposed for all symptomatic aneurysms, as well as VAA larger than 2 cm. Various therapeutic options are available for patients with VAA, including conventional open surgery, endovascular treatment and, most recently, laparoscopic surgery. Endovascular techniques, including transcatheter embolization and covered stent placement, can be used to treat most VAA regardless of the clinical presentation, etiology, or location of the aneurysm. If endovascular treatment is technically unavoidable, surgery should be considered given both good results and low morbidity. Surgical treatment with re-vascularisation should be offered for hepatic VAA interfering with the arterial supply of the liver.