3D rotational angiography in the endovascular treatment of visceral aneurysms: preliminary experience in a single centre.

ABSTRACT

OBJECTIVES: Endovascular embolization is a valid option for the management of visceral artery aneurysms. Imaging is crucial for providing anatomical assessments, but preoperative non-invasive investigations may not be exhaustive. The aim of this work is to present preliminary experience with the use of three-dimensional rotational angiography (3DRA) in this particular theatre. METHODS: Seven patients were treated for eight visceral aneurysms (six splenic and two renal) by endovascular embolization. 3DRA was performed before the treatment using a standard protocol. Different parameters (location of the lesion, the afferent and efferent vessels, aneurysm neck, vascular diameters, working incidence) were analyzed. RESULTS: 3DRA was successfully accomplished in all procedures. Mean aneurysm diameter was 23 mm and mean C-arm working incidence was 29° (R-L) and 9° (C-C). The sandwich technique was used in four lesions and the packing in the remaining four. Technical success was 100 %. The mean radiation dose per procedure was 291 600 mGy.cm(2). The mean procedural time was 2.25 hours. There were no immediate or short-term complications. CONCLUSIONS: 3DRA could be an interesting intraoperative tool to provide anatomical and technical assessments of the visceral arteries necessary for endovascular treatment, especially when information from preoperative imaging is not exhaustive. KEY POINTS Endovascular embolization is a valid alternative solution for visceral artery aneurysm treatment. Imaging is crucial for anatomical assessments and treatment guidance. 3DRA can contribute to endovascular treatment in lieu of preoperative imaging.