{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T15:11:02Z","timestamp":1773673862135,"version":"3.50.1"},"reference-count":49,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: Anatomical variations in visceral arteries are not so uncommon (up to 20% of cases in general population), with splenic and hepatic artery anomalies being the most frequently reported. Aberrant arteries may be affected with aneurysmal lesions that are rare but potentially fatal conditions. In their treatment, a comprehensive understanding and knowledge of the underlining anatomical variation are pivotal to prevent potential ischemic complications for the end organ. Methods: A comprehensive literature search on the PubMed, Cochrane and Scopus databases was done using the terms: \u201canomalous visceral artery aneurysm\u201d, \u201cAberrant visceral arteries\u201d, and \u201canomalous origin visceral vessels\u201d. Eligible studies published from inception to 30 June 2024 were identified. Only those that had included the adopted treatment strategies (open, endovascular or hybrid repair) and the related outcomes (mortality, bleeding, end-organ ischemia, lesions of the surrounding organ, need for reintervention) were analyzed to evaluate the safety and efficacy of each approach. A narrative analysis of the indications informing the selection of each interventional treatment, based on individual procedural risks, was also presented. Results: A total of 30 publications describing 36 patients (mean age 48.9 \u00b1 12.8 years, range 22\u201373 years) with aneurysms involving aberrant visceral arteries were included. Most patients were female (25\/36, 69.4%). True aneurysms predominated (with a mean size of 30.5 \u00b1 11.5 mm, range 6\u201360 mm), being reported in 33\/36 (91.7%) patients. Most lesions involved a splenic artery arising from the superior mesenteric artery (27\/36, 75.0%). Overall, 26\/36 (72.2%) patients were symptomatic upon presentation, most commonly with abdominal or epigastric pain, often associated with nausea or vomiting, back pain or shortness of breath. All patients underwent preoperative Computed angiotomography or subtraction angiography to define the operative strategy. Most cases were managed electively (31\/36, 86.1%), but 11.1% (4\/36) of cases required urgent intervention (in one case the urgency status was not specified). Overall, 19\/36 (52.8%) patients underwent purely endovascular repair, 15\/36 (41.7%) were treated with open surgery, and 2\/36 (5.6%) had hybrid procedures combining endovascular coiling with laparoscopic splenic artery ligation. Indication for treatment was based on vessel tortuosity, landing zones, and the presence of side branches supplying end organs. Early outcomes were favorable regardless of treatment strategies. A single organ-related complication was reported (1\/36, 2.8%) following open\/endovascular repair, consisting of mild pancreatitis, which resolved with conservative management. No perioperative or aneurysm-related deaths were reported in any of the included cases. No recurrent aneurysms or late aneurysm-related complications were described during the reported follow-up intervals (mean \u2248 10.5 months, range 1.5\u201342 months). Conclusions: Aneurysms arising from aberrant visceral arteries present unique challenges because their origin, course, and collateral networks deviate from standard anatomy. Patient selection and detailed anatomic mapping preoperatively are decisive as inadequate imaging or failure to recognize an aberrant origin can lead to the incomplete exclusion or inadvertent sacrifice of critical branches. Understanding the anatomy of visceral arteries and their variations is paramount in clinical practice, particularly when planning interventions for minimizing procedural risks, optimizing outcomes, and preventing potential complications. Contemporary practice favors endovascular repair due to lower perioperative morbidity, but success depends on vessel tortuosity, landing zones, and the presence of important side branches that supply end organs.<\/jats:p>","DOI":"10.3390\/jpm16030165","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T13:32:07Z","timestamp":1773667927000},"page":"165","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tailored Interventional Approaches to the Management of True and False Aneurysms Affecting Aberrant Visceral Arteries Are Associated with Enhanced Clinical Outcomes"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2422-5517","authenticated-orcid":false,"given":"Ottavia","family":"Borghese","sequence":"first","affiliation":[{"name":"Unit of Vascular Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arisa","family":"Ibrahimi","sequence":"additional","affiliation":[{"name":"Unit of Vascular Surgery, Department of Cardiovascular Sciences, Universit\u00e0 Cattolica del Sacro Cuore, 20123 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Luparelli","sequence":"additional","affiliation":[{"name":"Unit of Vascular Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Unit of Vascular Surgery, Department of Cardiovascular Sciences, Universit\u00e0 Cattolica del Sacro Cuore, 20123 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Piermarini","sequence":"additional","affiliation":[{"name":"Unit of Vascular Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Unit of Vascular Surgery, Department of Cardiovascular Sciences, Universit\u00e0 Cattolica del Sacro Cuore, 20123 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7304-7553","authenticated-orcid":false,"given":"Yamume","family":"Tshomba","sequence":"additional","affiliation":[{"name":"Unit of Vascular Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Unit of Vascular Surgery, Department of Cardiovascular Sciences, Universit\u00e0 Cattolica del Sacro Cuore, 20123 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/s00276-026-03825-x","article-title":"Splenic artery arising from the superior mesenteric artery: Analysis of morphological characteristics with contrast-enhanced CT images","volume":"48","author":"Tsukamoto","year":"2026","journal-title":"Surg. Radiol. Anat."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e155235","DOI":"10.3897\/folmed.67.e155235","article-title":"Celiac trunk variations\u2014Anatomy and clinical relevance","volume":"67","author":"Topalova","year":"2025","journal-title":"Folia Med."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Borghese, O., Pisani, A., Luparelli, A., Sica, S., Minelli, F., Donati, T., and Tshomba, Y. (2024). Endovascular Stent-Graft Repair of True and False Aneurysms of the Splenic Artery. J. Clin. Med., 13.","DOI":"10.3390\/jcm13102802"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3S","DOI":"10.1016\/j.jvs.2020.01.039","article-title":"The Society for Vascular Surgery clinical practice guidelines on the management of visceral aneurysms","volume":"72","author":"Chaer","year":"2020","journal-title":"J. Vasc. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1177\/1538574418785252","article-title":"Splenic Artery Aneurysm Treated with Endovascular Stent Grafting: A Case Report and Review of Literature","volume":"52","author":"Ouchi","year":"2018","journal-title":"Vasc. Endovasc. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"152385","DOI":"10.1016\/j.aanat.2025.152385","article-title":"Prevalence of coeliac trunk variants: A systematic review with meta-analysis","volume":"259","author":"Triantafyllou","year":"2025","journal-title":"Ann. Anat."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"b2535","DOI":"10.1136\/bmj.b2535","article-title":"Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement","volume":"339","author":"Moher","year":"2009","journal-title":"BMJ"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1186\/1752-1947-7-223","article-title":"The CARE guidelines: Consensus-based clinical case reporting guideline development","volume":"7","author":"Gagnier","year":"2013","journal-title":"J. Med. Case Rep."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.jclinepi.2017.04.026","article-title":"CARE guidelines for case reports: Explanation and elaboration document","volume":"89","author":"Riley","year":"2017","journal-title":"J. Clin. Epidemiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1097\/00000658-196707000-00017","article-title":"Aneurysm of anomalous splenic artery","volume":"166","author":"Ghatan","year":"1967","journal-title":"Ann. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1136\/pgmj.71.831.49","article-title":"Anomalous splenic artery aneurysm: Demonstration on CT scanning and angiography","volume":"71","author":"Sidhu","year":"1995","journal-title":"Postgrad. Med. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/S0741-5214(96)70085-X","article-title":"Aneurysms of anomalous splenomesenteric trunk: Clinical features and surgical management in two cases","volume":"24","author":"Settembrini","year":"1996","journal-title":"J. Vasc. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/S1078-5884(98)80043-9","article-title":"Reconstruction of the SMA after excision of an anomalous splenic artery aneurysm","volume":"15","author":"Patel","year":"1998","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1378","DOI":"10.1023\/B:DDAS.0000042233.14587.ef","article-title":"Visceral aneurysm and vascular anomaly involving the splenic artery","volume":"49","author":"Feo","year":"2004","journal-title":"Dig. Dis. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1007\/s10016-005-5048-0","article-title":"Managing anomalous splenic artery aneurysm: A review of the literature and report of two cases","volume":"19","author":"Migliara","year":"2005","journal-title":"Ann. Vasc. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1016\/j.jvs.2005.01.056","article-title":"A minimally invasive approach to the treatment of aberrant splenic artery aneurysms: A report of two cases","volume":"41","author":"Mastracci","year":"2005","journal-title":"J. Vasc. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1007\/s00270-005-0036-x","article-title":"Splenic artery aneurysm of the anomalous splenomesenteric trunk: Successful treatment by transcatheter embolization using detachable coils","volume":"29","author":"Sato","year":"2006","journal-title":"Cardiovasc. Interv. Radiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1177\/1538574406292005","article-title":"Operative management of an aberrant splenic artery aneurysm: Utility of the medial visceral rotation approach: A case report and review of the literature","volume":"40","author":"LaBella","year":"2006","journal-title":"Vasc. Endovasc. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.anchir.2006.01.009","article-title":"An\u00e9vrisme de l\u2019art\u00e8re spl\u00e9nique naissant de l\u2019art\u00e8re m\u00e9sent\u00e9rique sup\u00e9rieure: Strat\u00e9gie th\u00e9rapeutique","volume":"131","author":"Facy","year":"2006","journal-title":"Ann. Chir."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.avsg.2006.06.014","article-title":"Surgical repair of an aberrant splenic artery aneurysm: Report of a case","volume":"21","author":"Lluminati","year":"2007","journal-title":"Ann. Vasc. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1080\/13645700903201365","article-title":"Transcatheter coil embolization of an aneurysm of an anomalous splenic artery: Usefulness of double microcatheter method","volume":"18","author":"Tanigawa","year":"2009","journal-title":"Minim. Invasive Ther. Allied Technol."},{"key":"ref_23","first-page":"332","article-title":"Aneurysm of the splenic artery which arises from the superior mesenteric artery: A case report","volume":"110","author":"Lavigne","year":"2010","journal-title":"Acta Chir. Belg."},{"key":"ref_24","first-page":"e244","article-title":"Endovascular exclusion of aberrant splenic artery aneurysm with covered stent","volume":"52","author":"Taneja","year":"2011","journal-title":"Singap. Med. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.jvs.2010.11.116","article-title":"Endovascular stent-graft placement and coil embolization for an anomalous splenic artery aneurysm","volume":"54","author":"Jiang","year":"2011","journal-title":"J. Vasc. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1177\/1708538113478717","article-title":"Anomalous splenic artery aneurysm","volume":"21","author":"Wong","year":"2013","journal-title":"Vascular"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"931","DOI":"10.3348\/kjr.2013.14.6.931","article-title":"Endovascular treatment of aneurysm of splenic artery arising from splenomesentric trunk using stent graft","volume":"14","author":"Kulkarni","year":"2013","journal-title":"Korean J. Radiol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Zhou, W., Qiu, J., Yuan, Q., Zhou, W., Xiong, J., and Zeng, Q. (2014). Successful treatment of aberrant splenic artery aneurysm with a combination of coils embolization and covered stents. BMC Surg., 14.","DOI":"10.1186\/1471-2482-14-62"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"271","DOI":"10.3400\/avd.cr.15-00061","article-title":"Surgical Treatment of a Giant Right Hepatic Artery Aneurysm with an Aberrant Left Hepatic Artery: Report of a Case","volume":"8","author":"Shukuzawa","year":"2015","journal-title":"Ann. Vasc. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1177\/1538574417690344","article-title":"Endovascular Repair of a Splenic Artery Aneurysm With Anomalous Origin From the Superior Mesenteric Artery","volume":"51","author":"Jayakumar","year":"2017","journal-title":"Vasc. Endovasc. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.radcr.2018.05.006","article-title":"Acute upper gastrointestinal hemorrhage from a pseudoaneurysm of an unusual superior polar artery of the spleen","volume":"13","author":"Grippi","year":"2018","journal-title":"Radiol. Case Rep."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"309.e1","DOI":"10.1016\/j.avsg.2018.06.025","article-title":"Endovascular Repair of Anomalous Splenic Artery Aneurysm with Systemic Lupus Erythematosus","volume":"55","author":"Qiu","year":"2019","journal-title":"Ann. Vasc. Surg."},{"key":"ref_33","first-page":"42","article-title":"Endovascular treatment of multiple anomalous splenic artery aneurysms in a Jehovah witness","volume":"34","author":"Borioni","year":"2013","journal-title":"G. Chir."},{"key":"ref_34","first-page":"e7802","article-title":"Endovascular Intervention of a Mycotic Pseudoaneurysm of Accessory Left Hepatic Artery Arising from the Left Gastric Artery Presenting Secondary to Clostridium difficile Colitis: A Case Report","volume":"12","author":"Serena","year":"2020","journal-title":"Cureus"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"105618","DOI":"10.1016\/j.ijscr.2021.02.004","article-title":"Aneurysm of anomalous splenic artery arising from a splenomesenteric trunk: Review of the literature with a report of a new case","volume":"80","author":"Kakamad","year":"2021","journal-title":"Int. J. Surg. Case Rep."},{"key":"ref_36","first-page":"e14899","article-title":"A Ruptured Pseudoaneurysm of an Anomalous Gastroduodenal Artery: A Rare Presentation","volume":"13","author":"Shrestha","year":"2021","journal-title":"Cureus"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1016\/j.jvscit.2022.07.021","article-title":"Endovascular coil embolization for an anomalous splenic artery aneurysm with a splenomesenteric trunk","volume":"8","author":"Ichikawa","year":"2022","journal-title":"J. Vasc. Surg. Cases Innov. Tech."},{"key":"ref_38","first-page":"273","article-title":"Endovascular Stent Graft Placement and Coil Embolization for Splenic Artery Aneurysm with an Anatomical Variant","volume":"32","author":"Kuwada","year":"2022","journal-title":"Int. J. Angiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"101348","DOI":"10.1016\/j.jvscit.2023.101348","article-title":"Superior mesenteric aneurysm associated with median arcuate ligament syndrome and a single celiacomesenteric trunk","volume":"9","author":"Braet","year":"2023","journal-title":"J. Vasc. Surg. Cases Innov. Tech."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"25","DOI":"10.5758\/vsi.230055","article-title":"Endovascular Treatment of a Giant Aneurysm of the Aberrant Right Hepatic Artery in a Patient with Osler-Weber-Rendu Syndrome: A Case Report","volume":"39","year":"2023","journal-title":"Vasc. Spec. Int."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1067\/mva.2001.112320","article-title":"Visceral artery aneurysm rupture","volume":"33","author":"Carr","year":"2001","journal-title":"J. Vasc. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Hajibandeh, S., Hajibandeh, S., Alessandri, G., and de Liguori-Carino, N. (2026). Treatment Strategies for Management of True Hepatic Artery Aneurysms: A Systematic Review and Meta-Analysis. Am. Surg.","DOI":"10.1177\/00031348261425178"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Rascio, L., Peluso, N., Pascucci, D., Mangiacotti, L., Borghese, O., and Tshomba, Y. (2025). Interventional treatment for true aneurysm of superior mesenteric artery: A systematic review of the literature on open surgical strategies. Vascular.","DOI":"10.1177\/17085381251379848"},{"key":"ref_44","first-page":"612","article-title":"An\u00e9vrismes des art\u00e8res splanchniques: Du sympt\u00f4me au traitement [Splanchnic artery aneurysms: From symptoms to treatment]","volume":"21","author":"Brunschwig","year":"2025","journal-title":"Rev. Med. Suisse"},{"key":"ref_45","first-page":"395","article-title":"A review of SA aneurysms with a small subsection on aneurysms arising from a splenomesenteric trunk","volume":"30","author":"Shu","year":"2011","journal-title":"Int. Angiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2004","DOI":"10.1007\/s00330-015-3599-1","article-title":"Visceral artery aneurysms: Incidence, management, and outcome analysis in a tertiary care center over one decade","volume":"25","author":"Pitton","year":"2015","journal-title":"Eur. Radiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"49","DOI":"10.23736\/S0021-9509.23.12809-6","article-title":"Italian Guidelines for Vascular and Endovascular Surgery Collaborators. Guidelines on the diagnosis, treatment and management of visceral and renal arteries aneurysms: A joint assessment by the Italian Societies of Vascular and Endovascular Surgery (SICVE) and Medical and Interventional Radiology (SIRM)","volume":"65","author":"Pratesi","year":"2024","journal-title":"J. Cardiovasc. Surg."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1177\/15385744211028730","article-title":"The Minimally Invasive Treatment of Visceral Artery Pseudoaneurysms: A Retrospective Observational Single Centre Cohort Study on Glue Embolization","volume":"55","author":"Borghese","year":"2021","journal-title":"Vasc. Endovasc. Surg."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.avsg.2021.07.024","article-title":"Single Centre Experience in Open and Endovascular Treatment of Renal Artery Aneurysms","volume":"79","author":"Laurin","year":"2022","journal-title":"Ann. Vasc. Surg."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/16\/3\/165\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T13:50:07Z","timestamp":1773669007000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/16\/3\/165"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,16]]},"references-count":49,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["jpm16030165"],"URL":"https:\/\/doi.org\/10.3390\/jpm16030165","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,16]]}}}