Journal of Vascular and Endovascular Therapy

Endovascular Repair of Visceral Artery Aneurysms Decreases Length of Hospitalization

Objectives: Endovascular repair (EV) of visceral artery aneurysms (VAA) has risen. This study evaluates the outcomes of EV and open repair (OR) of VAA and compares splenic (SAA) to non-splenic (nsVAA) aneurysms.

Methods: Patients with VAA were identified from the Nationwide Inpatient Sample between 2003 and 2012. Demographics, comorbidities, complications and surgical outcomes of patients treated with EV and OR were compared. Patients were stratified into SAA and nsVAA and the same variables were compared between groups. Our primary end point was morbidity and mortality for treatment of VAA and the secondary end point was length of hospital stay after treatment.

Results: We identified 2561 VAA patients (1239 with SAA). The diagnosis of VAA rose throughout the study period. Patients treated for VAA rose from 62.8% in 2003 to 73.0% in 2012 (p<0.05). Of patients treated, those with EV rose from 26.8% in 2003 to 71.4% in 2012 (p<0.001) while those treated with OR fell from 73.2% to 28.6% (p<0.001). Mortality was not different between EV (3.8%) and OR (4.7%). Patients with OR experienced more postoperative complications (13.0% vs 9.7%, p<0.001). LOS was shorter for patients with EV (6.60 days vs 8.68, p<0.001).

Conclusion: The rate of EV repair for VAA has increased while OR is being used less. Mortality rates were similar for EV and OR. Patients with EV repairs experienced fewer complications and stayed two days shorter in the hospital than those with OR. SAA patients were younger, more likely to be female and had shorter LOS than nsVAA patients. With the increasing prevalence of VAA, EV procedures may be increasing the number of patients with VAA that can be treated.

Author(s):

Miller SM, Sumpio BJ, Miller MS, Erben Y, Cordova AC and Sumpio BE

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