Overview
This is a multicentric voluntary observational study with a retrospective evaluation of prospectively collected data concerning the treatment of visceral aneurysms with flow diversion stent Derivo Peripher and Derivo 2 (DED, Acandis GmbH) Follow-up will include clinical and radiological (CT) evaluation at least 12 months after the intervention.
The enrollment period will be of 65 months (01/jan/2020-30/jun/2025). Sample size will be of 100 patients.
Eligibility
Inclusion criteria:
- >18 years old
- Visceral artery aneurysms, evaluated with computed tomography angiography-CTAwithindication
for treatment according to 2020 SVS and 2024 SICVE/SIRM and 2024
CIRSE guidelines. Specifically:
- Renal artery: >2 cm if fusiform morphology or all dimensions if sacculary or bifurcation morphology, if in fertile women or in hypertensive patients with renal stenosis
- Splenic artery: if >2 cm, or all dimensions in fertile women.
- Celiac tripod: if >2 cm.
- Hepatic artery: if >2 cm or growth greater than 0.5 cm/year.
- Superior mesenteric artery, gastric or gastroepiploic artery, pancreaticoduodenal or gastroduodenal arteries, colic arteries, jejunal arteries, and ileal arteries: any size
- anatomical characteristics compatible with the stent DED Instruction for Use (IFU).
- Specifically
-
- the stent diameter should match the largest diameter of either the proximal or distal vessel of the aneurysm with an oversizing of 1-2 mm according to IFU.
- the stent length must allow for adequate proximal and distal landing, covering the neck of the aneurysm to 2.5 times the vessel's internal diameter and no less than 15 mm.
- proper adherence to the anticoagulant and antiplatelet pharmacological protocol for
the peri-procedural and post-procedural periods. Specifically:
- all patients should begin dual antiplatelet therapy (DAPT) before surgery (for at least 3 days before the procedure or with a loading dose pre-procedurally).
- all patients receive systemic anticoagulation during the procedure (Heparin 70 IU/kg to achieve an Activated Clot Time (ACT) > 250 s).
- after the procedure, the patient should continue DAPT (e.g., ASA 100 mg daily and Clopidogrel 75 mg daily) for at least 1 month, then continue with single antiplatelet therapy (e.g., ASA 100 mg) indefinitely.
Exclusion Criteria:
- patients who are hemodynamically unstable or show CT signs of rupture or contained rupture of visceral aneurysm
- pregnant or breastfeeding women
- life expectancy less than 2 years