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)
