Annals of Clinical and Medical

Case Reports

Research Paper ISSN 2639-8109 Volume 14

Splenic Artery Aneurysm

Young Woo Chung, Hong Sung Jung, Ho Kyun Lee, Sang Young Chung* and Soo Jin Na Choi
Division of Vascular Surgery, Department of Surgery, Chonnam National University Hospital, Gwangju Korea
Received: 26 Oct 2024 Copyright:
*
Corresponding author:
Accepted: 16 Nov 2024 ©2024 Sang Young Chung. This is an open access article
Sang Young Chung,
Published: 21 Nov 2024 distributed under the terms of the Creative Commons
Division of Vascular Surgery, Department of
J Short Name: ACMCR Attribution License, which permits unrestricted use, dis-
Surgery, Chonnam National University Hospital,
tribution, and build upon your work non-commercially
Gwangju Korea

Keywords: Citation:
Splenic Artery Aneurysms; Endovascular Treatment; Sang Young Chung, Splenic Artery Aneurysm.
Complication Ann Clin Med Case Rep. 2024; V14(9): 1-6

1. Abstract lar technologies, endovascular treatment of SAAs should be at-

1.1. Purpose tempted as first line treatment, especially in ruptured aneurysms
and even if relatively asymptomatic small aneurysms.
Splenic artery aneurysm (SAA) is uncommon disease. Reported
SAAs are increased because of advanced radiological diagnostic 2. Introduction
modalities. The aim of this study is to analyze of clinical findings Aneurysms is defined as an artery with an increased 50% diame-
of SAAs and to evaluate of endovascular therapies of SAAs. ter of artery than expected and result in mortality and morbidity
1.2. Materials and Methods [1, 2]. Splenic artery aneurysm (SAA) is uncommon. Large au-
topsy study revealed that an incidence of SAA is between 0.01
We retrospectively reviewed medical records of 37 consecutive
and 0.98%. The prevalence of SAA is not clear because most of
SAA from June 2009 to May 2023. 37 patients were treated by
SAA is asymptomatic [3]. Now more often diagnosed due to the
endovascular interventions with coils, plugs, stents and stent grafts.
increased use of cross-sectional imaging and an aging population
1.3. Results
[4, 5]. Rare but clinically important vascular condition because of
37 patients (9 males, 29 females) involved in the study with mean potential life-threatening disease. Recently SAA is extreme chal-
age was 58.1 years. Mean age for male was 69.8years. Mean age lenge in both emergency diagnosis and treatment. SAA is the most
for female was 56.3years. 32 patients were diagnosis incidentally. frequent visceral artery aneurysms, constituting 50–70% of viscer-
5 cases were complained abdominal pain. There was 3 pseudoan- al artery aneurysms [6]. In addition, SAA is the third most frequent
eurysms and 33 cases were saccular type. 4 patients were had 2 intraabdominal aneurysms, following abdominal aorta and iliac ar-
aneurysms. Mean aneurysm size was 2.4cm. Dome to neck ratio tery aneurysms [6, 7].
range was 1.6 to 2.8. Coil embolizations were performed in 25
3. Materials and Methods
cases and plug embolizations in 4 cases. 8 endovascular treatments
We retrospectively reviewed medical records of 37 consecutive
of SAA with a stent graft. 4 complications were noted. There was
SAA from June 2009 to May 2023. 37 patients were treated by
1 endoleak and treated by additional stent. Distal flow of splenic
endovascular interventions with coils, plugs, stents and stent
artery was not noted in 3 patients. 2 patients showed splenic infarc-
grafts. The study protocol was approved by the Institutional Re-
tion. 1 focal infarction patient was recovery after 1 year. Other 34
view Board of Chonnam National University Hospital. This study
patients had no complications. There was no splenic artery aneu-
was exempted from written informed consent due to retrospective
rysm associated mortality.
analysis based on medical records by Institutional Review Board.
1.4. Conclusion
The 3D-derived method uses Synapse picture archiving and com-
In endovascular era, with the development of modern endovascu- munication system (PACS) updates to automatically calculate the
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Volume 14 Issue 9 -2024 Research Paper

volume of contrast within an aneurysm. After importing CT angio- after endovascular intervention. There was 3 pseudoaneurysms
gram series into Synapse, a 3D reconstruction of the aneurysm is [Figure 2] and 33 cases were saccular type. 4 patients were had
formed. Aneurysms is defined as an artery with an increased 50% 2 aneurysms. Mean aneurysm size was 2.4cm and aneurysm size
diameter of adjacent artery. Statistical analysis was performed us- range was 1.2 to 7.2cm. Dome to neck ratio range was 1.6 to 2.8.
ing IBM SPSS Statistics ver 19.0 software (IBM Co., Armonk, At last follow up period, mean aneurysm size was 2.3cm in 25
NY, USA). Continuous data were compared using the Student’s patients. 3 patients had a limited increasing in the diameter of its
t-test and Fisher exact tests. SAA sac after coil embolization. 11 patients had calcified aneu-
4. Results rysm wall [Figure 3]. In location of splenic artery aneurysms were
extrasplenic 27 cases, juxtasplenic 3 cases and hilar 7 cases. Coil
78 patients (9 males, 69 females) involved in the study with mean
embolizations were performed in 25 cases and plug embolizations
age was 58.1 years. Mean age for male was 69.8years and age
in 4 cases. 8 endovascular treatments of SAA with a stent graft. 4
range was 51 to 80 years. Mean age for female was 56.3 and age
complications were noted. There was 1 endoleak during the stent
range was 26 to 77 years. 32 patients were diagnosis incidentally.
grafting and treated by additional stent [Figure 4]. Distal flow of
5 cases were complained abdominal pain. 1 case under the impres-
splenic artery was not noted in 3 patients. 2 patients showed splen-
sion of metastatic hepatocellular carcinoma and she has two fusi-
ic infarction. 1 focal infarction patient was recovery after 1 year
form type of SAAs [Figure 1]. This case was symptom aggravated
[Figure 5]. Other 34 patients had no complications. There was no
and grave prognosis. Other 4 patients were improved symptom
splenic artery aneurysm related mortality.

Figure 1: (A) Digital subtraction angiogram demonstrated two fusiform SAAs. (B) SAAs were treated by multiple coils and plugs embolizations.

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Volume 14 Issue 9 -2024 Research Paper

Figure 2: (A) Digital subtraction angiogram demonstrated pseudoaneurysm. (B) Pseudoaneurysm was excluded by stent-graft.

Figure 3: (A) Angiography showed 7.2cm sized SAA with calcified aneurysm wall(arrow). (B) There was no flow disturbance after coil embolization.

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Volume 14 Issue 9 -2024 Research Paper

Figure 4: (A) Angiography showed endoleak after stent graft. (B) This endoleak was treated by additional stent.

Figure 5: Spleen focal infarction was recovery after 1 year.

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Volume 14 Issue 9 -2024 Research Paper

5. Discussion in persons undergoing liver transplantation [26]. In endovascular

Etiological factor of true SAA is unclear, but arteriosclerosis era, with the development of modern endovascular technologies,
[6], portal hypertension [8, 9], multiparity, medial degeneration endovascular treatment of SAAs should be attempted as first line
[10,11], and fibromuscular dysplasia [12]. Other etiological fac- treatment, especially in ruptured aneurysms and even if relatively
tors of false or pseudoSAAs are intra-abdominal infectious or in- asymptomatic small aneurysms.
flammatory conditions [7, 13], and vasculitis, surgery, iatrogenic References
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