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Superior mesenteric artery aneurysm

Guidelines

Key sources

The following summarized guidelines for the evaluation and management of superior mesenteric artery aneurysm are prepared by our editorial team based on guidelines from the European Society for Vascular Surgery (ESVS 2025).
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Diagnostic investigations

Diagnostic imaging: as per ESVS 2025 guidelines, obtain CTA for diagnosis, anatomical characterization, and procedure planning in patients with suspected visceral artery aneurysm.
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Therapeutic procedures

Indications for repair: as per ESVS 2025 guidelines, perform urgent repair in patients with a symptomatic visceral artery aneurysm, regardless of size and location.
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Specific circumstances

Patients with mycotic aneurysms: as per ESVS 2025 guidelines, perform urgent open surgical intervention and administer antibiotic therapy in patients with a mycotic visceral artery aneurysm.
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More topics in this section

  • Patients with superior mesenteric artery dissection (conservative management)

  • Patients with superior mesenteric artery dissection (indications for repair)

  • Patients with superior mesenteric artery dissection (imaging surveillance)

Follow-up and surveillance

Surveillance imaging: as per ESVS 2025 guidelines, consider obtaining annual surveillance for the first 3 years and individualized thereafter, preferably with duplex ultrasound and otherwise CTA, in patients with an asymptomatic visceral artery aneurysm with a diameter < 30 mm.
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