Guideline sources The following summarized guidelines for the evaluation and management of gastric artery aneurysm are prepared by our editorial team based on guidelines from the Society for Vascular Surgery (SVS 2020). 1 Guidelines 1. Diagnostic investigations Diagnostic imaging: obtain CT angiography as the diagnostic tool of choice in patients with suspected gastric or gastroepiploic artery aneurysms. B Show 2 more Screening for other aneurysms: Consider obtaining abdominal axial imaging to screen for concomitant abdominal aneurysms. C Consider obtaining one-time screening CT angiography (or MRA) of the head, neck, and chest in patients with segmental arterial mediolysis. C 2. Therapeutic procedures Indications for repair: treat all gastric artery and gastroepiploic artery aneurysms of any size. B https://web.pathway.md/diseases/recyMknspseTSg3FI 1/2 6/24/23, 2:54 AM Gastric artery aneurysm Pathway Choice of repair: perform endovascular embolization as first-line treatment of gastric artery and gastroepiploic artery aneurysms. B 3. Follow-up and surveillance Surveillance imaging: Consider obtaining interval surveillance (every 12- 24 months) with axial imaging (CT angiography or MRA) in patients with segmental medial arteriolysis in light of reported cases of rapid arterial transformation. C Consider obtaining post-embolization surveillance every 1-2 years with axial imaging to assess for vascular remodeling and evidence of aneurysm reperfusion. C References 1. Rabih A Chaer, Christopher J Abularrage, Dawn M Coleman et al. The Society for Vascular Surgery clinical practice guidelines on the management of visceral aneurysms. J Vasc Surg. 2020 Jul;72 1S 3S 39S. Open https://web.pathway.md/diseases/recyMknspseTSg3FI 2/2