BACKGROUND: Visceral artery aneurysms (VAAs) are a relatively uncommon phenomenon, and all types of VAA occur at an incidence of 0.01% to 0.2%. The present study aims to describe the clinical characteristics and treatment outcomes of patients with VAAs treated at a Chilean academic institution over the past 40 years. METHODS: Single-center retrospective study of patients with VAAs surgically treated between August 1982 and May 2023. Data encompassing patient demographics, aneurysm characteristics, treatment modalities, and outcomes were analyzed. RESULTS: The cohort included 59 patients with 64 aneurysms, predominantly female (n = 35, 59.3%) with a median age of 51 years (range: 21-86 years). The most common VAAs were localized in the renal (n = 32, 50.0%) and splenic arteries (n = 20, 31.3%). Endovascular procedures were performed in 27 (42.2%) cases and open surgery in 37 (57.8%) cases. Two (3.1%) cases were treated with renal autotransplantation, aneurysmectomy was performed in three (4.7%) cases, prosthetic bypass in 10 cases (15.6%), and vein bypass in 22 cases (34.4%). Embolization was employed in 21 cases (32.8%), covered stenting in 5 cases (7.8%), and one case (1.6%) received both embolization and stenting. Technical success was 100% in the endovascular group versus 97.0% in the open group (P = 0.387). Overall, the complication rate was 6.7% (n = 4) with a 30-day mortality rate of 2.1% (n = 1). The median follow-up was 60.5 months (6-318 months), with a long-term mortality rate of 5.0% (n = 3). Patients operated on during the first time frame era, before the endovascular era, (1982-2002) had larger aneurysms than those operated on in the second time frame (2003-2023), with a median size of 30 mm versus 23 mm, respectively (P <
0.04). CONCLUSION: In the present study, both open repair and endovascular repair had similar surgical outcomes
however, the shift seen over time toward endovascular interventions aligns with current trends favoring less invasive procedures.