Guideline sources The following summarized guidelines for the evaluation and management of celiac 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: consider obtaining CT angiography as the initial diagnostic tool of choice for celiac artery aneurysms. C Show 3 more Screening for other aneurysms: consider screening patients with celiac artery aneurysms for other arterial aneurysms. C 2. Therapeutic procedures Indications for repair: perform emergent intervention for ruptured celiac artery aneurysms. A Show 3 more Choice of repair: https://web.pathway.md/diseases/recIHRD1w5oloj3gu 1/2 6/29/23, 3:46 AM Celiac artery aneurysm Pathway Perform open surgery or appropriate endovascular intervention based on the patient's anatomy and underlying clinical condition in stable patients with ruptured celiac artery aneurysm diagnosed on preoperative imaging. B Consider performing endovascular intervention, if anatomically feasible, for the elective treatment of celiac artery aneurysm, recognizing that elective treatment may appropriately involve open surgical, endovascular or laparoscopic methods of intervention depending on the patient's anatomy and underlying clinical condition. C 3. Surgical interventions Surgical ligation: consider performing ligation if sufficient collateral circulation to the liver can be documented in patients with ruptured celiac artery aneurysm discovered at laparotomy. C 4. Follow-up and surveillance Surveillance imaging: Consider obtaining annual surveillance with CT angiography to assess for growth in size in patients with celiac artery aneurysm being observed with a nonoperative or noninterventional approach. C Consider obtaining periodic surveillance with appropriate imaging studies to assess for the possibility of endoleak or aneurysm reperfusion that could lead to a continued risk of aneurysm growth or rupture after endovascular intervention. 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/recIHRD1w5oloj3gu 2/2