SVS Guidelines Bundle

Visceral Aneurysms

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Recommendations 8 Celiac Artery Aneurysm (CAA) Recommendation Grade/ LOE 4. Screening 4.1 We suggest screening patients with CAAs for other arterial aneurysms. 2-B 5. Follow-up and surveillance 5.1 In patients in whom a CAA is being observed with a nonoperative or noninterventional approach, we suggest annual surveillance with CTA scans to assess for growth in size. 2-B 5.2. Aer endovascular intervention for CAAs, we suggest periodic surveillance with appropriate imaging studies to assess for the possibility of endoleak or other continued aneurysm perfusion that could lead to a continued risk of aneurysm growth or rupture. 2-B Gastric and Gastroepiploic Artery Aneurysms Recommendation Grade/ LOE 1. Diagnosis and evaluation 1.1 In patients who are thought to have gastric or gastroepiploic artery aneurysms, we recommend CTA as the diagnostic tool of choice. 1-B 1.2 In patients who are thought to have gastric or gastroepiploic artery aneurysms and have high radiation exposure risks or renal insufficiency, we recommend non-contrast-enhanced MRA for diagnosis. Technical remark: Non-contrast-enhanced MRA is best suited to children and women of childbearing potential or those who have contraindications to CTA or MRA contrast materials (ie, pregnancy, renal insufficiency, or gadolinium contrast material allerg y). 1-C 1.3 We recommend the use of catheter-based angiography for all emergent cases presenting with rupture (Grade 1B) and electively for preoperative planning (Grade 1C). 1-B 1-C 2. Size criteria for invasive intervention 2.1 We recommend treatment of all gastric artery and gastroepiploic artery aneurysms of any size. 1-B 3. Treatment options 3.1 We recommend endovascular embolization for first-line treatment of gastric artery and gastroepiploic artery aneurysms. 1-B (cont'd)

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