SVS Guidelines Bundle

Visceral Aneurysms

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11 Superior Mesenteric Artery Aneurysm (SMAA) Recommendation Grade/ LOE 1. Diagnosis and evaluation 1.1 In patients with SMAA, we recommend CTA as the diagnostic tool of choice. 1-B 1.2 We recommend mesenteric angiography to delineate anatomy in preoperative planning for SMAA repair. 1-B 2. Size criteria for invasive intervention (true and false aneurysms) 2.1 We recommend repair of all SMAAs and pseudoaneurysms as soon as the diagnosis is made regardless of size. 1-A 2.2 We suggest careful observation of SMAA because of dissection unless refractory symptoms develop. 2-B 3. Treatment options 3.1 We recommend an endovascular-first approach to all SMAAs if it is anatomically feasible. 1-B 4. Screening for concomitant aneurysm 4.1 We suggest abdominal axial imaging to screen for concomitant intraabdominal aneurysms in patients who did not have CTA at the time of diagnosis. 2-B 5. Follow-up and surveillance 5.1 We suggest annual CTA to observe postsurgical patients. 2-B

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