SIR 2024
Arterial Interventions and Peripheral Arterial Disease (PAD)
Daniel Burke, IV, BS (he/him/his)
Medical Student
Kaiser Permanente School of Medicine
Financial relationships: Full list of relationships is listed on the CME information page.
Kavenpreet Bal, MS
Medical Student
Kaiser Permanente Bernard J. Tyson School of Medicine
Financial relationships: Full list of relationships is listed on the CME information page.
Kevin Zhou, BA
Medical Student
Kaiser Permanente School of Medicine
Disclosure information not submitted.
Alok Bhatt, MD
Assistant Program Director of Vascular and Interventional Integrated Residency
Kaiser Permanente physician
Financial relationships: Full list of relationships is listed on the CME information page.
Learn a high-level overview of the anatomic distribution, etiology, and natural history of visceral aneurysms
Recognize indications and risks associated with visceral aneurysm repair, including surgery and endovascular techniques
Understand the Society for Vascular Surgery’s 2020 guidelines on visceral aneurysm diagnostics and repair, including key findings and recommendations
Synthesize guideline findings with recent literature on visceral aneurysm repair
Visceral aneurysms, involving the celiac, superior, and inferior mesenteric arteries and their branches, are rare but clinically significant vascular conditions, with rupture conferring a high risk of intra abdominal hemorrhage and mortality {1,2,3}. The repair of visceral aneurysms through surgery or endovascular techniques is crucial for emergent aneurysms at significant risk of dissection and rupture {4,5}. However, there is great diversity in natural history, anatomical considerations for repair, and patient selection for surgical or endovascular repair across the spectrum of visceral aneurysms. This educational exhibit will review contemporary guidelines on the diagnostic and management criteria of visceral aneurysms {1,3}, and identify recently published trials to inform the practice of visceral aneurysm repair {6-8}.
Clinical Findings/Procedure Details:
This exhibit will: Provide a practical review of visceral aneurysm diagnostics and repair Review society guidelines for visceral aneurysm repair, including the 2017 European Society of Vascular Surgery and 2020 Society for Vascular Surgery, with a focus on vessel-specific approaches and postoperative risks Discuss the strength of recommendations and quality of evidence in contemporary guidelines, including areas of conflict between society-specific guidelines Review updates in the visceral aneurysm repair literature, including current gaps and topics of controversy {6-8} Visceral aneurysm rupture is associated with a significant risk of intra abdominal hemorrhage and mortality. The diversity of visceral aneurysms warrants special consideration of available evidence on natural history, surgical and endovascular approaches, and risk of postoperative complications in order to optimally manage visceral aneurysms. Society guidelines provide a wealth of cohesive recommendations for evidence-based visceral management: however, gaps continue to exist in the contemporary literature, particularly in the management of vessel-specific treatment failure.
Conclusion and/or Teaching Points: