A narrative review of pediatric peripheral arterial aneurysms

Background: Pediatric peripheral arterial aneurysms are uncommon and their natural history and management protocols are not well-defined. Methods: This is a single-center retrospective review of medical records of pediatric peripheral arterial aneurysms along with their treatment, outcomes and genet...

Full description

Saved in:
Bibliographic Details
Main Authors: Yashashwini Sudina, MS, Prajna B. Kota, MS, MCh, Vijaya Tourani, MD, Prem Chand Gupta, MS
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:JVS-Vascular Insights
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2949912725000613
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849336503286628352
author Yashashwini Sudina, MS
Prajna B. Kota, MS, MCh
Vijaya Tourani, MD
Prem Chand Gupta, MS
author_facet Yashashwini Sudina, MS
Prajna B. Kota, MS, MCh
Vijaya Tourani, MD
Prem Chand Gupta, MS
author_sort Yashashwini Sudina, MS
collection DOAJ
description Background: Pediatric peripheral arterial aneurysms are uncommon and their natural history and management protocols are not well-defined. Methods: This is a single-center retrospective review of medical records of pediatric peripheral arterial aneurysms along with their treatment, outcomes and genetic studies. We also performed a systematic review of the literature on pediatric arterial aneurysms. Results: From our records we identified five aneurysms in five children involving the radial, facial, subclavian, costocervical trunk, and axillary arteries. All aneurysms were treated surgically with good outcomes and genetic studies were abnormal in four of the five patients. Histopathology was nonspecific for any etiology and showed myxoid degeneration of the tunica media for all aneurysms. This systematic review included 147 articles from 6484 publications that were used for synthesis. We included 195 children with 321 aneurysms in this analysis. There was a male preponderance (63.4%) with mean age of 6.3 years (range 2 days to 18 years). Iliac artery was most frequently affected (26.8%), followed by brachial artery (19.3%). Nearly one-third had bilateral aneurysms and 43% had aneurysms at multiple sites. Concurrent visceral aneurysms, predominantly aortic, renal, and coronary were seen in 55 children (37.4%). The commonest etiology was idiopathic (41%) followed by Kawasaki disease (23.5%) and infection (7.2%). Genetic testing was done for 14 children, with 7 having a contributing genetic component. Treatment protocols included medical management, open surgery, endovascular intervention, hybrid repairs, and observation only. Conclusions: Pediatric arterial aneurysms can be treated surgically with good outcomes and may often be associated with genetic abnormalities. The approach to treatment is diverse, and it is difficult to recommend a standardized protocol.
format Article
id doaj-art-a294cd2c1e894c7bb9d7ab7ddc596461
institution Kabale University
issn 2949-9127
language English
publishDate 2025-01-01
publisher Elsevier
record_format Article
series JVS-Vascular Insights
spelling doaj-art-a294cd2c1e894c7bb9d7ab7ddc5964612025-08-20T03:44:57ZengElsevierJVS-Vascular Insights2949-91272025-01-01310024410.1016/j.jvsvi.2025.100244A narrative review of pediatric peripheral arterial aneurysmsYashashwini Sudina, MS0Prajna B. Kota, MS, MCh1Vijaya Tourani, MD2Prem Chand Gupta, MS3Vascular Division, Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PADivision of Vascular and Thoracic Surgery, Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, IndiaDepartment of Pathology, Care Hospitals, Hyderabad, IndiaDepartment of Vascular Surgery, Care Hospitals, Hyderabad, India; Correspondence: Prem Chand Gupta, MS, Clinical Director and Chief, Department of Vascular Surgery, Care Hospital, Road No 10, Banjara Hills, Hyderabad 500034, IndiaBackground: Pediatric peripheral arterial aneurysms are uncommon and their natural history and management protocols are not well-defined. Methods: This is a single-center retrospective review of medical records of pediatric peripheral arterial aneurysms along with their treatment, outcomes and genetic studies. We also performed a systematic review of the literature on pediatric arterial aneurysms. Results: From our records we identified five aneurysms in five children involving the radial, facial, subclavian, costocervical trunk, and axillary arteries. All aneurysms were treated surgically with good outcomes and genetic studies were abnormal in four of the five patients. Histopathology was nonspecific for any etiology and showed myxoid degeneration of the tunica media for all aneurysms. This systematic review included 147 articles from 6484 publications that were used for synthesis. We included 195 children with 321 aneurysms in this analysis. There was a male preponderance (63.4%) with mean age of 6.3 years (range 2 days to 18 years). Iliac artery was most frequently affected (26.8%), followed by brachial artery (19.3%). Nearly one-third had bilateral aneurysms and 43% had aneurysms at multiple sites. Concurrent visceral aneurysms, predominantly aortic, renal, and coronary were seen in 55 children (37.4%). The commonest etiology was idiopathic (41%) followed by Kawasaki disease (23.5%) and infection (7.2%). Genetic testing was done for 14 children, with 7 having a contributing genetic component. Treatment protocols included medical management, open surgery, endovascular intervention, hybrid repairs, and observation only. Conclusions: Pediatric arterial aneurysms can be treated surgically with good outcomes and may often be associated with genetic abnormalities. The approach to treatment is diverse, and it is difficult to recommend a standardized protocol.http://www.sciencedirect.com/science/article/pii/S2949912725000613Arterial aneurysmChildrenGenetic study
spellingShingle Yashashwini Sudina, MS
Prajna B. Kota, MS, MCh
Vijaya Tourani, MD
Prem Chand Gupta, MS
A narrative review of pediatric peripheral arterial aneurysms
JVS-Vascular Insights
Arterial aneurysm
Children
Genetic study
title A narrative review of pediatric peripheral arterial aneurysms
title_full A narrative review of pediatric peripheral arterial aneurysms
title_fullStr A narrative review of pediatric peripheral arterial aneurysms
title_full_unstemmed A narrative review of pediatric peripheral arterial aneurysms
title_short A narrative review of pediatric peripheral arterial aneurysms
title_sort narrative review of pediatric peripheral arterial aneurysms
topic Arterial aneurysm
Children
Genetic study
url http://www.sciencedirect.com/science/article/pii/S2949912725000613
work_keys_str_mv AT yashashwinisudinams anarrativereviewofpediatricperipheralarterialaneurysms
AT prajnabkotamsmch anarrativereviewofpediatricperipheralarterialaneurysms
AT vijayatouranimd anarrativereviewofpediatricperipheralarterialaneurysms
AT premchandguptams anarrativereviewofpediatricperipheralarterialaneurysms
AT yashashwinisudinams narrativereviewofpediatricperipheralarterialaneurysms
AT prajnabkotamsmch narrativereviewofpediatricperipheralarterialaneurysms
AT vijayatouranimd narrativereviewofpediatricperipheralarterialaneurysms
AT premchandguptams narrativereviewofpediatricperipheralarterialaneurysms