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Appropriateness Criteria

Reference Study Type Patients/Events Study Objective(Purpose of Study) Study Results Study Quality
10. Tulsyan N, Kashyap VS, Greenberg RK, et al. The endovascular management of visceral artery aneurysms and pseudoaneurysms. J Vasc Surg. 45(2):276-83; discussion 283, 2007 Feb. Observational-Tx 90 patients To review the outcomes of the management of visceral artery aneurysms with catheter-based techniques. The endovascular treatment of visceral artery aneurysms was technically successful in 98% of 48 procedures, consisting of 3 celiac axis repairs, 2 left gastric arteries, 1 SMA, 12 hepatic arteries, 20 splenic arteries, 7 gastroduodenal arteries, 1 middle colic artery, and 2 pancreaticoduodenal arteries. Of these, 29 (60%) were performed for symptomatic disease (5 ruptured aneurysms). Procedures were performed in the endovascular suite under local anesthesia with conscious sedation (94%). The femoral artery was used as the preferential access site (90%). Coil embolization was used for aneurysm exclusion in 96%. N-butyl-2-cyanoacrylate (glue) was used selectively (19%) using a triaxial system with a 3F microcatheter for persistent flow or multiple branches. The 30-day mortality was 8.3% (n = 4). One patient died from recurrent gastrointestinal bleeding after gastroduodenal embolization, and the remaining died of unrelated causes. All perioperative deaths occurred in patients requiring urgent or emergent intervention in the setting of hemodynamic instability. No patients undergoing elective intervention died in the periprocedural period. Postprocedural imaging was performed after 77% of interventions at a mean of 16 months. Complete exclusion of flow within the aneurysm sac occurred in 97% interventions with follow-up imaging, but coil and glue artifact complicated CT evaluation. Postembolization syndrome developed in three patients (6%) after splenic artery embolization. There was no evidence of hepatic insufficiency or bowel ischemia after either hepatic or mesenteric artery aneurysm treatment. Three patients required secondary interventions for persistent flow (n = 1) and recurrent bleeding from previously embolized aneurysms (n = 2). 2
15. Scheirey CD, Fowler KJ, Therrien JA, et al. ACR Appropriateness Criteria® Acute Nonlocalized Abdominal Pain. J Am Coll Radiol 2018;15:S217-S31. Review/Other-Dx N/A Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for acute nonlocalized abdominal pain. No results stated in abstract. 4
16. Schieda N, Blaichman JI, Costa AF, et al. Gadolinium-Based Contrast Agents in Kidney Disease: A Comprehensive Review and Clinical Practice Guideline Issued by the Canadian Association of Radiologists. Can J Kidney Health Dis. 2018;5():2054358118778573. Review/Other-Dx N/A To address the discrepancy between existing Canadian guidelines regarding use of gadolinium-based contrast agents (GBCA) in renal impairment and nephrogenic systemic fibrosis (NSF). In patients with category G2 or G3 CKD (eGFR = 30 and < 60 mL/min/1.73 m2), administration of standard doses of GBCA is safe and no additional precautions are necessary. In patients with AKI, with category G4 or G5 CKD (eGFR < 30 mL/min/1.73 m2) or on dialysis, administration of GBCA should be considered individually and alternative imaging modalities utilized whenever possible. If GBCA are necessary, newer GBCA may be administered with patient consent obtained by a physician (or their delegate) citing an exceedingly low risk (much less than 1%) of developing NSF. Standard GBCA dosing should be used; half or quarter dosing is not recommended and repeat injections should be avoided. Dialysis-dependent patients should receive dialysis; however, initiating dialysis or switching from peritoneal to hemodialysis to reduce the risk of NSF is unproven. Use of a macrocyclic ionic instead of macrocyclic nonionic GBCA or macrocyclic instead of newer linear GBCA to further prevent NSF is unproven. Gadopentetate dimeglumine, gadodiamide, and gadoversetamide remain absolutely contraindicated in patients with AKI, those with category G4 or G5 CKD, or those on dialysis. The panel agreed that screening for renal disease is important but less critical when using macrocyclic and newer linear GBCA. Monitoring for and reporting of potential cases of NSF in patients with AKI or CKD who have received GBCA is recommended. 4
17. Liu Q, Lu JP, Wang F, et al. Visceral artery aneurysms: evaluation using 3D contrast-enhanced MR angiography. AJR Am J Roentgenol. 191(3):826-33, 2008 Sep. Review/Other-Dx N/A Visceral artery aneurysms are uncommon, but they are clinically important because of the high incidence of rupture and life-threatening hemorrhage. Visceral artery aneurysms in patients with vascular anatomic variations are extremely rare, but detecting these variations is significant in this setting to determine the best treatment strategy; therefore, a thorough assessment of the aneurysm and of the vascular anatomy before treatment is paramount. No results stated in the abstract. 4
18. Pilleul F, Beuf O. Diagnosis of splanchnic artery aneurysms and pseudoaneurysms, with special reference to contrast enhanced 3D magnetic resonance angiography: a review. Acta Radiol. 2004 Nov;45(7):702-8. Review/Other-Dx N/A To discuss the technical aspects of 3D contrast-enhanced magnetic resonance angiography and illustrate various splanchnic artery aneurysms-pseudoaneurysms with their main characteristics. No results stated in abstract. 4
19. Hagspiel KD, Flors L, Hanley M, Norton PT. Computed tomography angiography and magnetic resonance angiography imaging of the mesenteric vasculature. [Review]. Tech Vasc Interv Radiol. 18(1):2-13, 2015 Mar. Review/Other-Dx N/A To provide an introduction to the CTA and MRA imaging protocol to study the mesenteric vasculature, the imaging findings in patients presenting with acute and chronic mesenteric ischemia and visceral aneurysms, and the value of these imaging techniques for therapy planning and follow-up. No results stated in abstract 4
20. Meaney JF. Non-invasive evaluation of the visceral arteries with magnetic resonance angiography. [Review] [32 refs]. Eur Radiol. 9(7):1267-76, 1999. Review/Other-Dx N/A MR arteriography and venography allows comprehensive evaluation of both visceral artery anatomy and function. No results stated in abstract. 4
21. Leiner T. Magnetic resonance angiography of abdominal and lower extremity vasculature. [Review] [237 refs]. Top Magn Reson Imaging. 16(1):21-66, 2005 Feb. Review/Other-Dx N/A To review the fundamentals of the different magnetic resonance angiographic techniques and how they can be applied for abdominal and peripheral arterial imaging. No results stated in abstract. 4
22. Laissy JP, Trillaud H, Douek P. MR angiography: noninvasive vascular imaging of the abdomen. [Review] [74 refs]. Abdom Imaging. 27(5):488-506, 2002 Sep-Oct. Review/Other-Dx N/A To review role of MRA in imaging the abdomen. MRA is as accurate as DSA in the diagnosis of portal vein diseases. AMI is an emergency in which CT is the most appropriate imaging modality. Conversely, chronic mesenteric ischemia is best examined with contrast-enhanced MRA, which is almost as accurate as DSA. Contrast-enhanced MRA is superior to DSA for the simultaneous exploration of the aorta, renal arteries, and iliac arteries, thereby providing a panoramic view of abdominal vascular involvement. MRA can be coupled with measurements of flow. With this functional approach, MRA is the only modality that can completely assess vascular diseases of the abdomen. 4
23. Barger AV, Block WF, Toropov Y, Grist TM, Mistretta CA. Time-resolved contrast-enhanced imaging with isotropic resolution and broad coverage using an undersampled 3D projection trajectory. Magn Reson Med. 2002 Aug;48(2):297-305. Review/Other-Dx N/A Time-resolved contrast-enhanced 3D MR angiography (MRA) methods have gained in popularity but are still limited by the tradeoff between spatial and temporal resolution. No results stated in abstract. 4
24. Ernst O, Asnar V, Sergent G, et al. Comparing contrast-enhanced breath-hold MR angiography and conventional angiography in the evaluation of mesenteric circulation. AJR Am J Roentgenol. 174(2):433-9, 2000 Feb. Observational-Dx 33 patients; 2 reviewers Prospective study to compare the results of gadolinium-enhanced breath-hold MRA with those of conventional angiography for the study of mesenteric circulation. Standard reference was selective conventional angiography. Agreement was good or excellent for the hepatic artery (kappa = 0.78), the SMA (kappa = 0.65), the splenic artery (kappa = 0.70), the portal vein (kappa = 1.0), the superior mesenteric vein (kappa = 0.88), and the splenic vein (kappa = 0.75). Agreement was poor, and vessels were better shown by conventional angiography, for the intrahepatic arteries (kappa = 0.006) and the branches of the SMA (kappa = 0.14). MRA and conventional angiography revealed 29 and 27 portosystemic collaterals, respectively. However, conventional angiography is still necessary to evaluate distal arteries. 2
25. Carlos RC, Stanley JC, Stafford-Johnson D, Prince MR. Interobserver variability in the evaluation of chronic mesenteric ischemia with gadolinium-enhanced MR angiography. Acad Radiol. 8(9):879-87, 2001 Sep. Review/Other-Dx 26 patients (20 women and six men) To assess interobserver variability in the interpretation of gadolinium-enhanced magnetic resonance (MR) angiograms of splanchnic vessels in patients suspected of having chronic mesenteric ischemia (CMI). With grade 2 stenosis used as a threshold, cumulative accuracies for detecting significant stenosis were 0.95 (95% confidence interval, 0.86-0.99) for reader A and 0.97 (0.88-1.0) for reader B. Interobserver agreement for grading proximal splanchnic stenosis was 0.90 for CA, 0.92 for SMA, and 0.48 for IMA. 4
26. Meaney JF, Prince MR, Nostrant TT, Stanley JC. Gadolinium-enhanced MR angiography of visceral arteries in patients with suspected chronic mesenteric ischemia. J Magn Reson Imaging. 7(1):171-6, 1997 Jan-Feb. Observational-Dx 14 patients had MR imaging findings availabe To evaluate accuracy of dynamic gadolinium-enhanced MRA of the celiac, superior, and inferior mesenteric arteries in patients with suspected mesenteric ischemia compared with catheter angiography or surgery. Overall sensitivity and specificity were 100% and 95%, respectively, compared with catheter angiography and surgery. The two errors were caused by overgrading the severity of IMA disease. 3D gadolinium-enhanced MRA can accurately demonstrate the origins of the celiac artery and SMA and is useful in evaluation of patients with suspected mesenteric ischemia. 3
27. Wasser MN, Geelkerken RH, Kouwenhoven M, et al. Systolically gated 3D phase contrast MRA of mesenteric arteries in suspected mesenteric ischemia. J Comput Assist Tomogr. 20(2):262-8, 1996 Mar-Apr. Observational-Dx 24 patients (2 female, 22 male) To assess the value of MRA for detecting stenoses in the celiac (CA) and superior mesenteric (SMA) arteries in patients suspected of having chronic mesenteric ischemia, using an optimized systolically gated 3D phase contrast technique. In the initial study, systolic gating appeared to be essential in imaging the SMA on 3D-PCA. In 10 patients suspected of mesenteric ischemia, systolically gated 3D-PCA identified significant proximal disease in the two mesenteric vessels in 4 patients. These patients underwent sucessful reconstruction of their stenotic vessels. 3
28. Horton KM, Smith C, Fishman EK. MDCT and 3D CT angiography of splanchnic artery aneurysms. [Review] [31 refs]. AJR Am J Roentgenol. 189(3):641-7, 2007 Sep. Review/Other-Dx N/A To review our experience with the use of MDCT and 3D imaging in the detection and management of patients with both symptomatic and asymptomatic splanchnic artery aneurysms. No results stated in abstract. 4
29. Horton KM, Fishman EK. CT angiography of the mesenteric circulation. [Review] [53 refs]. Radiol Clin North Am. 48(2):331-45, viii, 2010 Mar. Review/Other-Dx N/A To examine the technique of MDCT and its role in imaging the mesenteric circulation. No results in abstract 4
30. Cikrit DF, Harris VJ, Hemmer CG, et al. Comparison of spiral CT scan and arteriography for evaluation of renal and visceral arteries. Ann Vasc Surg. 10(2):109-16, 1996 Mar. Observational-Dx 32 patients To compare spiral CT scans with conventional arteriographs. Indications for imaging were occlusive disease (n = 12), aneurysmal disease (n = 9), and renal or visceral artery disease (n = 11). Conventional arteriography enabled visualization of 64 renal arteries and 15 accessory renal arteries.  Lateral aortograms obtained in 15 patients enabled visualization of 14 superior mesenteric  (SMA) and 14 celiac arteries. Spiral CT enabled visualization of 60 renal arteries, 12 accessory  renal arteries, 27 SMAs, and 22 celiac arteries. Calcification or a disparity in timing of contrast  material injection and scanning prevented visualization of the celiac artery in 10 patients and  the SMA in four patients. With conventional arteriography as the standard for comparison, spiral CT had a sensitivity of 67% and a specificity of 95% for depiction of at least 75% stenosis  in the main renal artery. By means of the Pearson correlation coefficient, significant correlation  &I c 0.001) was confirmed between spiral CT and arteriography for evaluation of stenosis of  the main renal artery, SMA, and celiac artery. 1
31. Chappell ET, Moure FC, Good MC. Comparison of computed tomographic angiography with digital subtraction angiography in the diagnosis of cerebral aneurysms: a meta-analysis. Neurosurgery. 2003 Mar;52(3):624-31; discussion 630-1. Meta-analysis 21 studies To compare a novel diagnostic radiological technique, computed tomographic angiography (CTA), with the standard method, namely digital subtraction angiography (DSA), in the diagnosis of cerebral aneurysms. Twenty-one references met the criteria for use in the meta-analysis. Unweighted calculations based on data for 1251 patients resulted in a sensitivity of 0.933 (93.3%; range, 75.4-100%) and a specificity of 0.878 (87.8%; range, 0-100%). When the studies were weighted for the number of patients in each study, the sensitivity decreased slightly, to 0.927 (92.7%), and the specificity decreased more substantially, to 0.772 (77.2%). Good
32. McKinney AM, Palmer CS, Truwit CL, Karagulle A, Teksam M. Detection of aneurysms by 64-section multidetector CT angiography in patients acutely suspected of having an intracranial aneurysm and comparison with digital subtraction and 3D rotational angiography. AJNR Am J Neuroradiol. 2008;29(3):594-602. Observational-Dx 63 subjects To determine the accuracy of 64-section MSCTA (64MSCTA) in aneurysm detection versus combined digital subtraction angiography (DSA) and 3D rotational angiography (3DRA). A total of 41 aneurysms were found in 28 patients. The mean size was 6.09 mm on DSA/3DRA and 5.98 mm on 64MSCTA. kappa was excellent (0.97) between the aneurysm size on 64MSCTA and DSA/3DRA. Ultimately, 37 aneurysms were detected by DSA/3DRA in 25 of the 36 patients who underwent conventional angiography. The reviewers noted four 1- to 1.5-mm sessile outpouchings only on 3DRA; none were considered a source of SAH. One 64MSCTA was false positive, whereas one 2-mm aneurysm was missed by CTA. The sensitivity of CTA for aneurysms less than 4 mm was 92.3%, whereas it was 100% for those 4-10 mm and more than 10 mm, excluding the indeterminate, sessile lesions. 2
33. Jia Z, Huang Y, Shi H, et al. Comparison of CTA and DSA in the diagnosis of superior mesenteric artery dissecting aneurysm. Vascular. 26(4):346-351, 2018 Aug. Review/Other-Dx 14 patients To compare computed tomography arteriography (CTA) and digital subtraction arteriography (DSA) in the diagnosis of superior mesenteric artery dissecting aneurysm (SMADA). Fourteen patients (12 men; mean age, 55.1 ± 6.4 years) were included in this study. The mean diameter of the dissecting aneurysm was 3.78 ± 1.53 mm on CTA and 3.81 ± 1.54 mm on DSA ( p = 0.96). The luminal stenosis was 0.52 ± 0.27 on CTA and 0.35 ± 0.23 on DSA ( p = 0.09). The thrombosed false lumen was visualized on CTA in 79% (11/14) of patients but in no patients on DSA ( p < 0.001). The entry points of the dissection were visualized on CTA in 64.3% (9/14) of patients and on DSA in 100% (14/14) of patients ( p = 0.041); CTA and DSA did not visualize re-entry points in any patients. The intimal flap was visualized on CTA in 71.4% (10/14) of patients and on DSA in 78.6% (11/14) of patients ( p > 0.05). Branch vessel involvement was visualized in 7.1% (1/14) of patients on CTA but in no patients on DSA ( p > 0.05). 4
34. Chiesa R, Astore D, Guzzo G, et al. Visceral artery aneurysms. Ann Vasc Surg. 2005 Jan;19(1):42-8. Review/Other-Dx 28 patients to review our experience with VAA treatment. The most common locations were the splenic artery (16) and the hepatic artery (7). Three patients underwent emergency surgery, 22 patients had elective open surgery, and 7 patients underwent endovascular treatment. In the surgical group the perioperative mortality rate was 3.6%. The perioperative morbidity rate was 7.1% (one case of respiratory distress manifested in the immediate postoperative period and one urgent case of bilious fistula). In the endovascular group none of the patients died; the perioperative morbidity rate was of 14.3% (one case of hepatic artery thrombosis after failure of gastroduodenal artery aneurysm embolization). Failure of the procedure was 42.9% (3 cases of aneurysm recanalization). 4
35. Chadha M, Ahuja C. Visceral artery aneurysms: diagnosis and percutaneous management. Semin Intervent Radiol. 2009 Sep;26(3):196-206. Review/Other-Dx N/A Advances in endovascular management with various aneurysmal isolation techniques are discussed. No results stated in abstract. 4
36. Frauenfelder T, Wildermuth S, Marincek B, Boehm T. Nontraumatic emergent abdominal vascular conditions: advantages of multi-detector row CT and three-dimensional imaging. Radiographics. 24(2):481-96, 2004 Mar-Apr. Review/Other-Dx 11 patients To describe the protocols used in 11 patients with conditions including ruptured abdominal aortic aneurysm, secondary aortoduodenal fistula, splanchnic segmental arterial mediolysis, and Wegener-type vasculitis with visceral involvement. No results stated in the abstract. 4
37. Zhang LJ, Wu SY, Niu JB, et al. Dual-energy CT angiography in the evaluation of intracranial aneurysms: image quality, radiation dose, and comparison with 3D rotational digital subtraction angiography. AJR Am J Roentgenol. 2010 Jan;194(1):23-30. Observational-Dx 46 The purpose of this study was to evaluate the image quality, radiation dose, and diagnostic accuracy of dual-energy CT angiography (CTA) compared with 3D rotational digital subtraction angiography (DSA) in the detection of intracranial aneurysms. There was no statistical difference between the image quality of dual-energy CTA and that of digital subtraction CTA (p>0.05). Patients undergoing dual-energy CTA received a smaller radiation dose (volume CT dose index, 20.6+/-0.1 mGy [mean+/-SD]; dose-length product, 398.6+/-19.0 mGy x cm) than those undergoing digital subtraction CTA (volume CT dose index, 50.4+/-3.4 mGy; dose-length product, 1,095.6+/-114.2 mGyxcm) (p<0.05). Three-dimensional DSA showed no aneurysm in 11 patients and 40 aneurysms in 35 patients. The mean maximum diameter of the aneurysms was 6+/-3 mm; the dome measurement, 5+/-3 mm; and the neck dimension, 3+/-2 mm. With dual-energy CTA, 38 aneurysms in 34 patients were correctly detected, and two aneurysms in two patients were missed. With DSA as the standard of reference, the sensitivity, specificity, and positive and negative predictive values of dual-energy CTA in the detection of intracranial aneurysm were 97.1%, 100%, 100%, and 91.7% on a per-patient basis and 95.0%, 100%, 100%, and 99.7% on a per-aneurysm basis. Dual-energy CTA had sensitivities of 93.8%, 100%, and 80.0% and specificities of 100%, 100%, and 100% in the detection of aneurysms larger than 5 mm, those measuring 3.1-5 mm, and aneurysms 3 mm or smaller. At dual-energy CTA, the mean maximum diameter and dome and neck dimensions were 6+/-3 mm, 5+/-3 mm, and 3+/-2 mm. Excellent correlation was found between DSA and dual-energy CTA findings with respect to mean maximum diameter and dome and neck dimensions (r=0.969, 0.957, and 0.870; p = 0.000). 1
38. Saba L, Anzidei M, Lucatelli P, Mallarini G. The multidetector computed tomography angiography (MDCTA) in the diagnosis of splenic artery aneurysm and pseudoaneurysm. [Review]. Acta Radiol. 52(5):488-98, 2011 Jun 01. Review/Other-Dx N/A To provide a review of the general characteristics of splenic artery aneurysms and pseudoaneurysms and to describe the findings of multidetector computed tomography angiography (MDCTA). No results stated in the abstract. 4
39. Badea R. Splanchnic artery aneurysms: the diagnostic contribution of ultrasonography in correlation with other imaging methods. J Gastrointestin Liver Dis. 2008 Mar;17(1):101-5. Review/Other-Dx N/A To discuss the diagnostic contribution of ultrasonography in correlation with other imaging methods for splanchnic artery aneurysms. No results stated in the abstract. 4
40. Ishida H, Konno K, Hamashima Y, et al. Splenic artery aneurysm: value of color Doppler and the limitation of gray-scale ultrasonography. Abdom Imaging. 23(6):627-32, 1998 Nov-Dec. Review/Other-Dx 5 patients To reevaluate the advantages and limitations of gray-scale and color Doppler sonography in the diagnosis of splenic artery (Sp-A) aneurysm. Gray-scale sonography failed to detect the aneurysm in four of five cases because of a surrounding splenorenal (Sp-R) shunt in three patients and marked calcification of the aneurysmal wall in one patient. Pulsed Doppler sonography showed a slightly turbulent pulsatile flow along the aneurysmal wall, which immediately led to the diagnosis in four cases, including the three cases with Sp-R shunt. In one case, color Doppler sonography failed to detect the aneurysm because of a markedly calcified aneurysmal wall, although power Doppler sonography could visualize the aneurysm. 4
41. Li X, Staub D, Rafailidis V, Al-Natour M, Kalva S, Partovi S. Contrast-enhanced ultrasound of the abdominal aorta - current status and future perspectives. Vasa. 48(2):115-125, 2019 Mar. Review/Other-Dx N/A Contrast-enhanced ultrasound (CEUS) is a complementary tool and is useful in assessing both the macro- and microvascular anatomy of the aorta. No results stated in abstract. 4
42. Li X, Cokkinos D, Gadani S, et al. Advanced ultrasound techniques in arterial diseases. [Review]. Int J Cardiovasc Imaging. 38(8):1711-1721, 2022 Aug. Review/Other-Dx N/A To review the clinical applications of advanced sonographic techniques for the assessment of vascular diseases. No results in abstract. 4
43. Pfister K, Kasprzak P, Oikonomou K, et al. [Management of Visceral Artery Aneurysms with Preservation of Organ Perfusion: More Than Twenty Years Experience]. Zentralbl Chir. 2018 Oct;143(5):516-525. Review/Other-Dx 179 patients To evaluate our data and experience of more than 20 years and to develop a strategy to deal with visceral artery aneurysm in elective and emergency cases. A total of 69 patients underwent open or endovascular repair. 51 (74%) pts were treated electively, 18 (26%) pts presented urgently with acute bleeding. 16 emergency pts received endovascular treatment, and in 2 pts open surgery was performed. After emergency treatment, two pts exhibited segmental liver malperfusion without consequences. In one case, segmental bowel resection was necessary. 32/51 (63%) patients were treated electively by open surgery, 19/51 (37%) by endovascular procedures. There were no liver or bowel infarctions. Four splenectomies and one unilateral nephrectomy were necessary in patients with splenic or renal artery aneurysms. Moreover, three partial renal infarctions were noticed postoperatively (overall 8/21 [38%]). After endovascular repair of splenic or renal artery aneurysms, two cases of splenic and three cases of renal segmental infarction were observed. Splenectomy had to be performed twice (overall 7/14 [50%]). Organ perfusion was monitored by CTA, and preferentially by contrast enhanced ultrasound. 4
44. Gunabushanam G, Chaubal R, Scoutt LM. Doppler Ultrasound of the Renal Vasculature. [Review]. J Ultrasound Med. 43(8):1543-1562, 2024 Aug. Review/Other-Dx N/A To review the ultrasound imaging findings of various pathologies involving the renal vessels, including the renal arteries (atherosclerotic stenosis, fibromuscular dysplasia, dissection, arteriovenous fistula, and aneurysm) and veins (tumor and bland thrombus as well as vascular compression syndromes). No results stated in abstract. 4
45. Maruno M, Kiyosue H, Tanoue S, Hongo N, Kashiwagi J, Mori H. Unenhanced magnetic resonance angiography with time-spatial labeling inversion pulse for evaluating visceral artery aneurysms after endosaccular packing with detachable coils: preliminary results. J Vasc Interv Radiol. 24(2):289-93, 2013 Feb. Review/Other-Dx 8 patients To compare unenhanced magnetic resonance (MR) angiography with time-spatial labeling inversion pulse (Time-SLIP) with conventional digital subtraction angiography (DSA) in assessing degree of saccular visceral artery aneurysm (VAA) occlusion after endosaccular packing with detachable coils. No results stated in abstract. 4
46. Bultman EM, Klaers J, Johnson KM, et al. Non-contrast enhanced 3D SSFP MRA of the renal allograft vasculature: a comparison between radial linear combination and Cartesian inflow-weighted acquisitions. Magn Reson Imaging. 32(2):190-5, 2014 Feb. Observational-Dx 21 patients To evaluate the performance of a non-inflow weighted 3D radial balanced steady-state free precession acquisition – VIPR-SSFP – in renal NCE-MRA compared to Inflow IR (IFIR). Diagnostic efficacy of the sequences was scored using a four point Likert scale according to the following criteria: overall image quality, fat suppression, and arterial/venous visualization quality. Average scores for each criterion were compared using the Wilcoxon signed-rank test. In addition to significantly improved venous visualization, the VIPR-SSFP sequence provided significantly improved fat suppression quality (p<0.03) compared to IFIR. VIPR-SSFP also identified several pathologies such as renal arterial pseudoaneurysm that were not visible on the IFIR images. However, IFIR afforded superior quality of arterial visualization (p<0.005). 3
47. Mori R, Kassai Y, Masuda A, et al. Ultrashort echo time time-spatial labeling inversion pulse magnetic resonance angiography with denoising deep learning reconstruction for the assessment of abdominal visceral arteries. J Magn Reson Imaging. 53(6):1926-1937, 2021 06. Review/Other-Dx 13 patients to investigate and compare image quality (IQ) and susceptibility artifacts of three-dimensional (3D) ultrashort echo time (UTE) time-spatial labeling inversion pulse (Time-SLIP) with those of 3D bSSFP Time-SLIP and to assess denoising deep learning reconstruction (dDLR) for the improvement of the signal-to-noise ratio (SNR) in 3D UTE with sparse sampling in phantoms and human subjects. Ten healthy volunteers (seven males) and three patients (two males) were included in this study. 3D UTE Time-SLIP and 3D bSSFP Time-SLIP at 3T were used. The phantom-based study compared the signal-intensity ratio of the device levels (SRdevice ) and distal segments (SRdistal ) to the proximal segments. The volunteer-based study measured SNR, contrast ratio (CR), and IQ. The patient study evaluated local artifacts from metallic devices. Statistical tests included paired t-tests, Wilcoxon-signed rank tests, and Kruskal-Wallis tests. In the phantom-based study, SRdevice was small with UTE Time-SLIP, except the stainless-steel stent. SRdistal was greater (49.1%-90.4%) on bSSFP images than UTE images (-11.1% to 9.6%). Among volunteers, dDLR in UTE images improved SNR (p < 0.05) and IQ (p < 0.05), but CR was unaffected. UTE Time-SLIP showed inferior SNR and IQ than bSSFP Time-SLIP in images with and without dDLR (p < 0.05 for each). However, among patients, UTE Time-SLIP showed reduced metal artifacts compared to bSSFP Time-SLIP. Irrespective of the lower SNR and IQ of 3D UTE Time-SLIP than those of 3D bSSFP Time-SLIP, the former appeared to better depict flow after stenting or coiling. This indicates the potential of 3D UTE Time-SLIP to provide suitable diagnostic images of target vessels. dDLR improved SNR with reducing artifacts related to radial sampling, while maintaining the contrast. 4
48. Gietzen C, Janssen JP, Görtz L, et al. Non-contrast-enhanced MR-angiography of the abdominal arteries: intraindividual comparison between relaxation-enhanced angiography without contrast and triggering (REACT) and 4D contrast-enhanced MR-angiography. Abdom Radiol (NY). 2025 Apr;50(4):1887-1898. Observational-Dx 30 patients To evaluate Relaxation-Enhanced Angiography without Contrast and Triggering (REACT), a novel 3D isotropic flow-independent non-contrast-enhanced magnetic resonance angiography (non-CE-MRA) for imaging of the abdominal arteries, by comparing image quality and assessment of vessel stenosis intraindidually with 4D CE-MRA. REACT had a total acquisition time of 5:36 ± 00:40 min, while 4D CE-MRA showed a total acquisition time (including the native scan and bolus tracking sequence) of 3:45 ± 00:59 min (p = 0.001). Considering 4D CE-MRA as the reference standard, REACT achieved a sensitivity of 87.5% and specificity of 100.0% for relevant (= 50%) stenosis while detecting 89.5% of all vascular findings other than stenosis. For all vessels combined, subjective vessel quality was slightly higher in 4D CE-MRA (3.0 [IQR: 2.0; 4.0.]; P = 0.040), although comparable to REACT (3.0 [IQR: 2.0; 3.5]). 2
49. Barrionuevo P, Malas MB, Nejim B, et al. A systematic review and meta-analysis of the management of visceral artery aneurysms. J Vasc Surg. 70(5):1694-1699, 2019 11. Review/Other-Dx 80 observational studies To summarize the best available evidence of comparing open to endovascular approaches for visceral artery aneurysms (VAAs). We included 80 observational studies that were mostly noncomparative. Data were available for 2845 aneurysms, comprising 1279 renal artery, 775 splenic artery, 359 hepatic artery, 226 pancreaticoduodenal and gastroduodenal arteries, 95 superior mesenteric artery, 87 celiac artery, 15 jejunal, ileal and colic arteries, and 9 gastric and gastroepiploic arteries. Differences in mortality between open and endovascular approaches were not statistically significant. The endovascular approach was used more often by surgeons. The endovascular approach was associated with shorter hospital stay and lower rates of cardiovascular complications but higher rates of reintervention. Postembolization syndrome rates ranged from 9% (renal) to 38% (splenic). Coil migration ranged from 8% (splenic) to 29% (renal). Otherwise, access site complication were low (<5%). Pseudoaneurysms tended to have higher mortality and reintervention rates. 4
50. Loffroy R, Favelier S, Pottecher P, et al. Endovascular management of visceral artery aneurysms: When to watch, when to intervene?. World J Radiol. 7(7):143-8, 2015 Jul 28. Review/Other-Dx N/A For most asymptomatic aneurysms, expectant treatment is acceptable. For large, symptomatic or aneurysms with a high risk of rupture, endovascular treatment has become the first-line therapy. Treatment of VAPAs is always mandatory because of the high risk of rupture. We present our point of view on interventional radiology in the splanchnic arteries, focusing on what has been achieved and the remaining challenges. No results stated in abstract. 4
51. Hong Z, Chen F, Yang J, Wu Z, Yan Z. Diagnosis and treatment of splanchnic artery aneurysms: a report of 57 cases. Chin Med J. 112(1):29-33, 1999 Jan. Observational-Dx 57 To evaluate the diagnosis and treatment of splanchnic artery aneurysms. Preoperative diagnosis was confirmed by arteriography in 37 patients, digital subtraction angiography (DSA) in 2, and magnetic resonance angiography (MRA) in 2. Among the 46 patients who underwent surgical intervention, 9 died. Splanchnic arterial embolotherapy was performed in 6 patients. 3
52. Etezadi V, Gandhi RT, Benenati JF, et al. Endovascular treatment of visceral and renal artery aneurysms. J Vasc Interv Radiol. 22(9):1246-53, 2011 Sep. Review/Other-Dx 40 To analyze early and midterm results of endovascular treatment of visceral aneurysms regarding technical considerations, technical success rate, aneurysm rupture, and end-organ ischemia. Forty-one aneurysms underwent endovascular treatment. Hypertension (73%) and hyperlipidemia (32%) were the most common associated comorbidities. Nineteen patients presented with symptoms of pain (15%) or rupture (32%) in 10 pseudoaneurysms (91%) and nine true aneurysms (30%; P = .0007). The most commonly used technique (93%) was coil embolization with (15%) or without (78%) other endovascular agents. The rate of technical success (cessation of hemorrhage or blood flow into aneurysm sac) was 98%. There was no periprocedural mortality. Mean hospital stays were 1 and 2 days for asymptomatic and symptomatic patients, respectively. Mean clinical follow-up was 44.5 months; mean imaging follow-up was 11.7 months. The only complication was an intraprocedural thromboembolic event in one case (3%). Follow-up imaging evidence of end-organ partial infarct was detected in six patients (21%), with no clinical evidence of organ insufficiency. 4
53. Kok HK, Asadi H, Sheehan M, Given MF, Lee MJ. Systematic Review and Single-Center Experience for Endovascular Management of Visceral and Renal Artery Aneurysms. [Review]. J Vasc Interv Radiol. 27(11):1630-1641, 2016 Nov. Review/Other-Dx 22 studies To report a systematic review of endovascular management of visceral and renal artery aneurysms (VRAA) and results at a tertiary referral center. The systematic review included 22 studies published between 2005 and 2016 describing endovascular treatment of VRAA. In the systematic review cohort, 646 aneurysms (432 true, 151 false, 63 unclassified) were treated using endovascular methods with 93.2% technical success, 99.3% visceral preservation, 3.5% major complication (classified based on Society of Interventional Radiology criteria), 1.5% 30-day periprocedural mortality, and 4.6% reintervention rates. In the local cohort, 19 aneurysms (12 true, 7 false) were treated with 100% technical success, 94.7% visceral preservation, and 10.5% major complication rates. There was no periprocedural mortality. Over mean follow-up of 31.9 months (range, 2-170 months), there were 2 aneurysm reperfusions, which required no further treatment. Results incorporating data from the systematic review and local cohorts (665 aneurysms) showed 93.6% technical success, 99.1% visceral preservation, 3.7% major complication, 1.5% periprocedural mortality, and 4.4% reintervention rates. 4
54. Ruhnke H, Kroncke TJ. Visceral Artery Aneurysms and Pseudoaneurysms: Retrospective Analysis of Interventional Endovascular Therapy of 43 Aneurysms. ROFO Fortschr Geb Rontgenstr Nuklearmed. 189(7):632-639, 2017 Jul. Observational-Dx 38 To evaluate the results of interventional endovascular therapy of incidental and symptomatic visceral artery aneurysms in the elective and emergency situation. 23 true aneurysms (maximum diameter: 22 ± 18 mm [11 - 67 mm]) and 20 false aneurysms (maximum diameter: 9 ± 33 mm [3 - 150 mm]) were evaluated. The splenic (n = 14) and renal arteries (n = 18) were most frequently affected. The etiology was most commonly degenerative-atherosclerotic (47 %) or iatrogenic post-operative (19 %). 18/48 interventions were performed due to active bleeding. False aneurysms were associated significantly more often with active bleeding (63 vs. 25 %, p = 0.012). 41/48 treatments were technically successful. Re-intervention was necessary 6 times. In 2 cases the endovascular approach did not succeed. There was a complication rate of 10 %, whereby only 4 minor and 1 major complications occurred. No patient suffered from permanent sequelae. Aneurysms were primarily treated by using coils and if necessary additional embolic agents (liquid embolic agent or vascular plugs) (75 %). In the follow-up period, reperfusion of treated aneurysms occurred at a rate of 7 % (n = 3). 3
55. Venturini M, Marra P, Colombo M, et al. Endovascular Repair of 40 Visceral Artery Aneurysms and Pseudoaneurysms with the Viabahn Stent-Graft: Technical Aspects, Clinical Outcome and Mid-Term Patency. Cardiovasc Intervent Radiol. 41(3):385-397, 2018 Mar. Observational-Dx 40 Endovascular 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. SG 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. 3
56. Sheahan KP, Alam I, Pehlivan T, et al. A Qualitative Systematic Review of Endovascular Management of Renal Artery Aneurysms. [Review]. .J Vasc Interv Radiol. 35(8):1127-1138, 2024 Aug. Review/Other-Dx 427 patients To perform a qualitative systematic review of endovascular management of renal artery aneurysms (RAAs). Twenty-six, single-center, retrospective, observational studies were included. There were 454 RAAs treated in 427 patients using endovascular techniques. Mean age was 53.8 years, with a female predominance (62%). A variety of endovascular treatments of RAA were used with excellent technical success (96%), renal parenchymal preservation, and a low rate of moderate/severe adverse events (AEs). Primary coil embolization was the most commonly used technique (44.7%). There was an overall AE rate of 22.9%, of which 6.7% were moderate/severe and there was 0% periprocedural mortality. The most common AE was renal infarction (49 patients, 11.5%); however, renal function was preserved in 84% of patients. Nephrectomy rate was 0.4%. Computed tomography (CT) angiography was the most common imaging follow-up modality used in 72% of studies. Only 9 studies (34%) reported anticoagulant use. Although the risk of delayed aneurysm reperfusion warrants clinical and imaging surveillance, relatively few patients (3%) required reintervention in this cohort. 4
57. Shu K, Shao J, Lai Z, et al. Treatment strategy for splenic artery aneurysms and novel classification based on imaging. J Vasc Surg. 80(3):838-846.e1, 2024 Sep. Review/Other-Dx 113 patients To propose a novel classification system for SAAs based on aneurysm characteristics and to review treatment outcomes at our center. The study cohort of 113 patients with 127 SAAs had a predominance of female patients (63.7%) and a mean age of 52.7 years. The SAAs were classified into five types, with type I being the most common. The intervention techniques varied across types, with sac embolization, covered stent implantation, and artery embolization being the most frequently used. The overall technical success rate was 94.7%, with perioperative complication and reintervention rates of 25.0% and 0.9%, respectively, and no deaths within 30 days after the intervention. The median follow-up duration was 21 months, with overall complications rate of 3.5% and no aneurysm-related complications or deaths. 4
61. Gong C, Sun MS, Leng R, et al. Endovascular embolization of visceral artery aneurysm: a retrospective study. Sci Rep. 2023 Apr 28;13(1):6936. Review/Other-Dx 66 patients To explore the symptom profile and intrinsic associations of symptomatic visceral aneurysms. A retrospective study of 66 consecutive patients at two tertiary care hospitals from 2010 to 2020 compared the short- to mid-term outcomes of 22 symptomatic VAAs and 44 asymptomatic VAAs treated with coil embolization. Univariate and log-rank tests were used to analyze the prognostic impact of SVAA and ASVAA. SVAA group had significantly higher 30-day mortality than ASVAA group (2(9.1%) vs 0, P = 0.042), both patients who died had symptomatic pseudoaneurysms. Perioperative complications such as end-organ ischemia (P = 0.293) and reintervention (P = 1) were similar in both groups. No difference in event-free survival was identified between the two groups (P = 0.900), but we found that the majority of pseudoaneurysms were SVAA (4/5) and that they had a much higher event rate than true aneurysms. In addition, dyslipidemia may be an influential factor in the development of VAA (P = 0.010). 4
62. Koganemaru M, Abe T, Uchiyama D, et al. Detection of neck recanalization with follow-up contrast-enhanced MR angiography after renal artery aneurysm coil embolization. J Vasc Interv Radiol. 2010 Feb;21(2):298-300. Review/Other-Dx N/A To detect neck recanalization with follow-up contrast-enhanced MR angiography after renal artery aneurysm coil embolization. No abstract available. 4
63. Yamada N, Hayashi K, Murao K, Higashi M, Iihara K. Time-of-flight MR angiography targeted to coiled intracranial aneurysms is more sensitive to residual flow than is digital subtraction angiography. AJNR Am J Neuroradiol. 25(7):1154-7, 2004 Aug. Review/Other-Dx 39 patients To establish a noninvasive technique to visualize residual flow in coiled aneurysms. MRA visualized all parent and branch arteries with DSA confirmation. MRA visualized residual flow more frequently (38 studies) than did DSA (25 studies). Residual flow space visualized with MRA was always similar to or larger than that with DSA. The dark-blood sequence completely suppressed intraluminal high signal intensity on MRA images and confirmed that the high signal intensity was not due to thrombus. 4
64. Ferré JC, Carsin-Nicol B, Morandi X, et al. Time-of-flight MR angiography at 3T versus digital subtraction angiography in the imaging follow-up of 51 intracranial aneurysms treated with coils. Eur J Radiol. 2009 Dec;72(3):365-9. Observational-Dx 51 patients To compare 3D time-of-flight MR angiography (TOF-MRA) at 3 Tesla (3T) with digital subtraction angiography (DSA) for the evaluation of intracranial aneurysm occlusion after endovascular coiling. DSA images were not interpretable for one patient. Interobserver agreement was determined as excellent for DSA (kappa=0.86) and TOF-MRA (kappa=0.80). After reaching a consensus, DSA follow-up showed 26 (51%) complete obliterations, 20 (39%) residual necks and 4 (8%) residual aneurysms. TOF-MRA showed 23 (45%) complete obliterations, 22 (43%) residual necks and 6 (12%) residual aneurysms. Comparison between TOF-MRA and DSA showed excellent agreement between the techniques (kappa=0.86). In the four cases that were misclassified, TOF-MRA findings were assigned to a higher class than for DSA. 1
65. Kaufmann TJ, Huston J 3rd, Cloft HJ, et al. A prospective trial of 3T and 1.5T time-of-flight and contrast-enhanced MR angiography in the follow-up of coiled intracranial aneurysms. AJNR Am J Neuroradiol. 31(5):912-8, 2010 May. Observational-Dx 58 To prospectively compare 4 MRA techniques, TOF and CE-MRA at 1.5T and 3T, to a reference standard of DSA in the evaluation of previously endovascularly coiled intracranial aneurysms. For the detection of any aneurysm remnant, the sensitivity was 85%-90% for all MRA techniques. Sensitivity dropped to 50%-67% when calculated for the detection of only the class 3 and 4 aneurysm remnants, because several class 3 and 4 remnants were misclassified as class 2 by MRA. CE-MRA at 1.5T and 3T misclassified fewer of the class 3 and 4 remnants than did TOF-MRA at 1.5T, as reflected by the significantly greater sensitivity for larger aneurysm remnants with CE-MRA relative to TOF-MRA at 1.5T (P = .0455 for both comparisons). 2
66. Saltzberg SS, Maldonado TS, Lamparello PJ, et al. Is endovascular therapy the preferred treatment for all visceral artery aneurysms? Ann Vasc Surg. 2005 Jul;19(4):507-15. Review/Other-Dx 65 patients Endovascular intervention can provide an alternative method of treatment for visceral artery aneurysms. 39 splenic (SAA), 13 renal, seven celiac, three superior mesenteric (SMA), and three hepatic. Eleven patients (16.9%) had symptoms attributable to their aneurysms, which included a total of four ruptures (6.2%): three splenic and one hepatic. Management consisted of 18 (27.7%) endovascular interventions, nine (13.9%) open surgical repairs, and 38 (58.5%) observations. Mean aneurysm diameter for patients treated expectantly was significantly less than for those who underwent intervention (p = 0.001). Endovascular interventions included 15 (83.3%) embolizations (11 SAA, three renal, one hepatic) and three (16.7%) stent grafts (two SMA, one renal). The initial technical success rate of the endovascular procedures was 94.4% (17/18). However, there were four patients (22.2%) with major endovascular procedure-related complications: one late recurrence requiring open surgical repair, two large symptomatic splenic infarcts, and one episode of severe pancreatitis. These four patients had distal splenic artery aneurysms at or adjacent to the splenic hilum. 4
67. Al-Habbal Y, Christophi C, Muralidharan V. Aneurysms of the splenic artery - a review. [Review]. Surgeon Journal of the Royal Colleges of Surgeons of Edinburgh & Ireland. 8(4):223-31, 2010 Aug.Surg.. 8(4):223-31, 2010 Aug. Review/Other-Dx N/A To review the recent advances and current concepts in the management of splenic artery aneurysm (SAA). No results stated in the abstract. 4
68. Corey MR, Ergul EA, Cambria RP, et al. The natural history of splanchnic artery aneurysms and outcomes after operative intervention. J Vasc Surg. 63(4):949-57, 2016 Apr. Review/Other-Dx 250 patients To review our 20-year experience with managing splanchnic artery aneurysm. There were 264 SAAs identified in 250 patients. In 166 patients, 176 SAAs (66.6%) were placed into the surveillance cohort; 38 SAAs (21.6%) did not have subsequent axial imaging and were considered lost to follow-up. Mean aneurysm size in the surveillance cohort at first imaging study was 16.28 mm (8-41 mm), and mean surveillance time was 36.1 months (2-155 months); 126 SAAs (91.3%) remained stable in size over time, and 8 SAAs (5.8%) required intervention for aneurysm growth after a mean of 24 months. There were no ruptures in the surveillance cohort. There were 88 SAAs (33.3%) repaired early. Mean size of SAAs that were repaired early was 31.1 mm (10-140 mm). For intact SAAs, 30-day morbidity and mortality rates after repair were 13% and 3%, respectively. In the early repair cohort, 13 SAAs (14.7%) were ruptured at presentation. The 30-day morbidity and mortality rates after rupture were 54% and 8%, respectively. Five ruptured SAAs (38%) were anatomically located in the pancreaticoduodenal arcade. On univariate analysis, pancreaticoduodenal aneurysms were strongly associated with rupture (P = .0002). 4
69. Schanzer H, Papa MC, Miller CM. Rupture of surgically thrombosed abdominal aortic aneurysm. J Vasc Surg. 1985 Mar;2(2):278-80. Review/Other-Dx 67-year-old man To report a patient who presented with a rupture of a successfully thrombosed abdominal aortic aneurysm 2 years after having undergone ligation of both common iliac arteries,  embolization of the abdominal aortic aneurysm, and axillobifemoral bypass. No results in abstract. 4
70. Guillon R, Garcier JM, Abergel A, et al. Management of splenic artery aneurysms and false aneurysms with endovascular treatment in 12 patients. Cardiovasc Intervent Radiol. 26(3):256-60, 2003 May-Jun. Review/Other-Dx 12 To assess the endovascular treatment of splenic artery aneurysms and false aneurysms. Endovascular treatment was possible in 11 patients (92%) (one failure: stenting attempt). In four cases among 11, the initial treatment was not successful (residual perfusion of aneurysm); surgical treatment was carried out in one case, and a second embolization in two. Thus in nine cases (75%) endovascular treatment was successful: complete and persistent exclusion of the aneurysm but with spleen perfusion persisting at the end of follow-up on CT scans (mean 13 months). An early and transient elevation of pancreatic enzymes was observed in four cases. 4
71. Berceli SA. Hepatic and splenic artery aneurysms. [Review] [23 refs]. Semin Vasc Surg. 18(4):196-201, 2005 Dec. Review/Other-Dx N/A To delineate the fundamental characteristics and natural history of visceral aneurysms, review the current open surgical options for treatment, identify potential endovascular approaches formanagement, and present a critical review of where these various modalities should be incorporated in the current vascular surgery practice. No results in abstract. 4
72. Dorigo W, Pulli R, Azas L, et al. Early and Intermediate Results of Elective Endovascular Treatment of True Visceral Artery Aneurysms. Ann Vasc Surg. 2016 Jan;30():S0890-5096(15)00668-8. Review/Other-Dx 26 patients To analyze early and follow-up results of endovascular management of visceral artery aneurysms (VAAs) in a single-center experience. The site of aneurysm was splenic artery in 17 patients, common hepatic artery in 3 patients, renal artery and pancreaticoduodenal artery in 2 cases each, and gastroduodenal artery and celiac trunk in one case each. All the lesions were asymptomatic, and the mean diameter was 22.8 mm. Interventions consisted in coiling in 19 cases; in 4 patients a covered stent was placed, whereas the remaining 3 patients had a multilayer stent. Technical success was 89%. There were no perioperative deaths; 1 patient with splenic artery aneurysm had coils migration with symptomatic splenic infarction and underwent successful redo coils packing. Median duration of follow-up was 18 months. During follow-up, 1 aneurysm-unrelated death occurred. One asymptomatic thrombosis of a treated vessel was recorded, with a 2-year estimated patency rate of 91%. Mean aneurysmal diameter at the latest follow-up was 20.2 mm (P = 0.001 in comparison with preoperative values; 95% confidence interval 1.9-5.2). Complete exclusion of the aneurysm occurred in all but 1 patient, who had a limited increasing in the diameter of its splenic aneurysmal sac after coiling. Another patient developed a more distal aneurysm of the splenic artery after 24 months. No reinterventions were required. Freedom from aneurysm-related complications at 2 years was 72.9% (Standard Error, 0.09). 4
73. Carr SC, Pearce WH, Vogelzang RL, McCarthy WJ, Nemcek AA Jr, Yao JS. Current management of visceral artery aneurysms. Surgery. 120(4):627-33; discussion 633-4, 1996 Oct. Review/Other-Dx 37 patients To review a contemporary experience with special emphasis on newer methods of diagnosis and treatment. Seventeen patients were treated surgically, with no surgical deaths. Surgical complications included splenic abscess (two) and failure to thrombose (one). Transcatheter embolization was used in 12 patients. Complications included splenic infarction (one) and recurrence (two), successfully treated with repeat embolization. Nine patients were treated with observation. Eight experienced no complications during follow-up; one died of a ruptured splenic artery aneurysm before treatment was initiated. 4
74. Lakin RO, Bena JF, Sarac TP, et al. The contemporary management of splenic artery aneurysms. J Vasc Surg. 53(4):958-64; discussion 965, 2011 Apr. Observational-Dx 128 patients with SAAs To review our experience with open repair, endovascular therapy, and observation of splenic artery aneurysms (SAAs) over a 14-year interval. Patients (61 ± 11 years, 69% female) were investigated for abdominal symptoms (49%) or had the incidental finding of SAA (mean size, 2.4 ± 1.4 cm). Seven patients (5.5%) presented with rupture and were treated emergently with two perioperative mortalities (29%). Patients requiring surgical or endovascular treatment were more likely male (40% vs 21%, P = .031), younger (58 vs 64 years; P = .004), and current smokers (18% vs 5%; P = .035). Increased aneurysm calcification was associated with decreased SAA size (P = .013). The mean aneurysm size at initial diagnosis was 1.67 cm for patients undergoing observation and 3.13 cm for the treated group (P < .001). Endovascular repair was safe and durable with a mean 1.5-mm regression in SAA size over 2 years. The mean rate of growth for observed SAA was 0.2 mm/y. Ten-year survival was 89.4% (95% confidence interval: 82.0, 97.4) for all patients (observed group, 94.9%; treated group, 85.1%; P = .18). No late aneurysm-related mortality was identified. 4
75. Pitton MB, Dappa E, Jungmann F, et al. Visceral artery aneurysms: Incidence, management, and outcome analysis in a tertiary care center over one decade. Eur Radiol. 25(7):2004-14, 2015 Jul. Review/Other-Dx 233 patients To evaluate the incidence, management, and outcome of visceral artery aneurysms (VAA) over one decade. VAA were localized at the splenic artery, coeliac trunk, renal artery, hepatic artery, superior mesenteric artery, and other locations. The aetiology was degenerative, iatrogenic after medical procedures, connective tissue disease, and others. The rate of rupture was much higher in pseudoaneurysms than true aneurysms (76.3% vs.3.1%). Fifty-nine VAA were treated by intervention (n = 45) or surgery (n = 14). Interventions included embolization with coils or glue, covered stents, or combinations of these. Thirty-five cases with ruptured VAA were treated on an emergency basis. There was no difference in size between ruptured and non-ruptured VAA. After interventional treatment, the 30-day mortality was 6.7% in ruptured VAA compared to no mortality in non-ruptured cases. Follow-up included CT and/or MRI after a mean period of 18.0 ± 26.8 months. The current status of the patient was obtained by a structured telephone survey. 4
76. Sessa C, Tinelli G, Porcu P, Aubert A, Thony F, Magne JL. Treatment of visceral artery aneurysms: description of a retrospective series of 42 aneurysms in 34 patients. Ann Vasc Surg. 18(6):695-703, 2004 Nov. Review/Other-Dx 34 patients Visceral artery aneurysms (VAA) can be treated by revascularization, ligation, or, most often, endovascular techniques depending on clinical presentation, hemodynamic status, and location. 34 patients were treated. The lesion involved the splenic artery (SA; 19), pancreaticoduodenal artery (PDA; 6), celiac trunk (CT; 5), superior mesenteric artery (SNA; 4), common hepatic artery (CHA; 3), gastroduodenal artery (GDA; 2), left hepatic artery (LHA; 1), a branch of the inferior mesenteric artery (BIMA; 1), and a branch of the SMA (BSMA; 1). Twenty-seven VAA in 21 patients (64%) were uncomplicated (group I) and 15 VAA in 13 patients (36%) had ruptured (group II) (PDA; 6; CT, 3; SA, 1; CHA, 1; LHA, 1; BSMA, 1; BIMA, 1). In group I VAA were treated by embolization (n = 11), splenectomy (n = 6), bypass (n = 7), ligation (n = 2), and aneurysmorraphy (n = 1). No deaths were observed. The morbidity rate associated with surgical treatment was 12% including hepatic bypass thrombosis without ischemic complications in two cases. The morbidity rate associated with endovascular treatment was 18% including cholecystitis in one case and bile duct stenosis in one case. The VAA recanalization rate following embolization was 9%. In group II, 12 VAA (80%) were treated by ligation in association with splenectomy in two cases and left hepatectomy in one case. Only one bypass procedure was performed and embolization was used to treat two VAA (1 SMA and 1 PDA). The mortality rate was 20% (3/15). The morbidity rate associated with surgical treatment was 46% (6/13) including bile duct stenosis in one case, ischemic cholecystitis in one case, duodenal fistula in one case, pancreatic fistula in one case, bile tract fistula in one case, and colonic ischemia in one case. No patient died after endovascular treatment and the morbidity rate was 50% (1/2) with duodenal stenosis occurring in one case. In sum, VAA can rupture. 4
77. Hamamoto K, Chiba E, Oyama-Manabe N, et al. Ultra-short Echo-time MR Angiography Combined with a Modified Signal Targeting Alternating Radio Frequency with Asymmetric Inversion Slabs Technique to Assess Visceral Artery Aneurysm after Coil Embolization. Magn Reson Med Sci. 2024 Jan 01;23(1):110-121. Review/Other-Dx N/A To introduced a novel non-contrast-enhanced MR angiography technique using ultra-short TE combined with a modified signal targeting alternating radio frequency with asymmetric inversion slabs, which could provide a serial hemodynamic vascular image with fewer susceptibility artifacts for follow-up after coil embolization. No results stated in abstract. 4
78. Henke PK, Stanley JC. Renal artery aneurysms: diagnosis, management and outcomes. [Review] [29 refs]. Minerva Chir. 58(3):305-11, 2003 Jun. Review/Other-Dx N/A To review the diagnosis, management, and outcomes related to renal artery aneurysms (RAA). No results in abstract. 4
79. Hellmund A, Meyer C, Fingerhut D, Müller SC, Merz WM, Gembruch U. Rupture of renal artery aneurysm during late pregnancy: clinical features and diagnosis. Arch Gynecol Obstet. 2016 Mar;293(3):505-8. Review/Other-Dx 1 patient Rupture of renal artery aneurysm during pregnancy is a severe complication with high mortality and morbidity for mother and fetus, and diagnosis is difficult. Regarding all published cases up to now (n = 32), 65.6% of mothers and 40.6% of fetuses survived. The rupture occurred in 68.7% in the third trimester and in 6.3% shortly postpartum. In our case, the increase of maternal serum lactate in a hemodynamically stable patient lead to diagnosis. 4
80. Cohen JR, Shamash FS. Ruptured renal artery aneurysms during pregnancy. J Vasc Surg. 1987 Jul;6(1):51-9. Review/Other-Dx 18 cases Rupture of renal artery aneurysms during pregnancy has been associated with an extremely high mortality rate for both mother and fetus. 18 cases have been reported in the English language literature, of which only eight mothers (44%) and four fetuses (22%) have survived. Sixteen of the 18 cases (88%) involved rupture of the left renal artery. All ruptures occurred in the third trimester except one, which occurred late in the second trimester. 4
81. Suzuki K, Kashimura H, Sato M, et al. Pancreaticoduodenal artery aneurysms associated with celiac axis stenosis due to compression by median arcuate ligament and celiac plexus. J Gastroenterol. 1998 Jun;33(3):434-8. Review/Other-Dx 1 patient Celiac axis stenosis is frequently associated with pancreaticoduodenal artery aneurysms. No results stated in abstract. 4
82. Chaikof EL, Brewster DC, Dalman RL, et al. The care of patients with an abdominal aortic aneurysm: the Society for Vascular Surgery practice guidelines. [Review] [506 refs]. J Vasc Surg. 50(4 Suppl):S2-49, 2009 Oct. Review/Other-Dx N/A To provide recommendations for evaluating the patient, including risk of aneurysm rupture and associated medical comorbidities, guidelines for selecting surgical or endovascular intervention, intraoperative strategies, perioperative care, long-term follow-up, and treatment of late complications. No results stated. 4
83. Bjorck M, Koelemay M, Acosta S, et al. Editor's Choice - Management of the Diseases of Mesenteric Arteries and Veins: Clinical Practice Guidelines of the European Society of Vascular Surgery (ESVS). [Review]. Eur J Vasc Endovasc Surg. 53(4):460-510, 2017 04. Review/Other-Tx N/A No abstract available No abstract available 4
84. Pinto F, Miele V, Scaglione M, Pinto A. The use of contrast-enhanced ultrasound in blunt abdominal trauma: advantages and limitations. Acta Radiol. 2014 Sep;55(7):776-84. Review/Other-Dx N/A The introduction of a new contrast-enhanced ultrasound (CEUS) technique, using second-generation ultrasound contrast agents, has led to a notable increase in the diagnostic accuracy of US in many organs. No results stated in abstract. 4
85. Sidhu PS, Cantisani V, Dietrich CF, et al. The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound (CEUS) in Non-Hepatic Applications: Update 2017 (Long Version). Ultraschall Med. 2018 Apr;39(2):e2-e44.
86. Schwarze V, Marschner C, Negrao de Figueiredo G, Rubenthaler J, Clevert DA. Single-Center Study: Evaluating the Diagnostic Performance and Safety of Contrast-Enhanced Ultrasound (CEUS) in Pregnant Women to Assess Hepatic Lesions. Ultraschall in der Medizin. 41(1):29-35, 2020 Feb.Ultraschall Med. 41(1):29-35, 2020 Feb.
87. Alghamdi SA. Gadolinium-Based Contrast Agents in Pregnant Women: A Literature Review of MRI Safety. Cureus. 2023 May;15(5):e38493. Review/Other-Dx N/A To review literature on MRI safety during pregnancy in first trimester. No results in abstract. 4
88. Starekova J, Nagle SK, Schiebler ML, Reeder SB, Meduri VN. Pulmonary MRA During Pregnancy: Early Experience With Ferumoxytol. J Magn Reson Imaging. 57(6):1815-1818, 2023 06.
89. Nael K, Villablanca JP, Mossaz L, et al. 3-T contrast-enhanced MR angiography in evaluation of suspected intracranial aneurysm: comparison with MDCT angiography. AJR Am J Roentgenol. 2008 Feb;190(2):389-95. Observational-Dx 41 patients To prospectively evaluate a high-spatial-resolution contrast-enhanced 3-T MR angiography protocol for detection and characterization of intracranial aneurysms and to compare the results with those of MDCT angiography. A total of 25 aneurysms were identified with both contrast-enhanced MR angiography and CTA. A comparative analysis of detection and depiction of aneurysms showed excellent interobserver agreement for both contrast-enhanced MR angiography (kappa = 0.81) and CTA (kappa = 0.91) images. There was significant correlation between the techniques for both qualitative assessment of aneurysm depiction (rho = 0.92; 95% CI, 0.88-0.95) and quantitative dimensional measurement of aneurysm size (r = 0.94; 95% CI, 0.92-0.97). 2
95. Hamamoto K, Chiba E, Oyama-Manabe N, Shinmoto H. Ultra-short echo time magnetic resonance angiography using a modified signal targeting with alternative radio frequency spin labeling technique for detecting recanalized pulmonary arteriovenous malformation after coil embolization. Acta Radiol Open. 2021 Oct;10(10):20584601211057671. Review/Other-Dx N/A A case of recanalized PAVM after coil embolization detected by ultra-short echo time MR angiography using a modified signal targeting with an alternative radio frequency spin labeling technique. No results stated in abstract. 4
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