Abstract: Objective:To explore the clinical value and efficacy of interventional treatment for splenic artery aneurysm (SAA).
Methods:The clinical data of 14 patients with SAA who were admitted to the Shanghai Ninth People′s Hospital Affiliated to Shanghai Jiaotong University from January 2009 to December 2014 were retrospectively analyzed. The size, characteristic, diameter of splenic parent artery and location, shape and neck size of SAA in splenic artery were evaluated by preoperative computed tomography angiography (CTA). The proper interventional embolization was selected according to the results of preoperative imaging. The success of interventional embolization was confirmed by the results of digital subtraction angiography (DSA) of splenic artery including unobstructed parent artery, normal imaging of spleen and no retention and overflowing of contrast agent in the aneurismal cavity. All the patients received the outpatient reexaminations of CTA at postdischarged month 1 and month 6. The followup was performed up to June 2015.
Results:Of the 14 patients, 15 SAAs were detected, including 1 multiple SAA and 13 single SAAs. There were 2 pseudoaneurysms and 13 true aneurysms, and most of the aneurismal bodies were roundor ovalshaped. Five SAAs were located at the proximal ends of splenic artery, 7 at the middle ends of splenic artery and 3 at the distal ends of splenic artery. The diameter of aneurysm was 1.6-7.5 cm with a median of 3.7 cm. Fourteen patients received successful embolization with detachable coils. One patient with true SAA underwent successful embolization using bare metal stent (BMS) combined with detachable coils due to the large opening of SAA. One patient with multiple true SAA received simultaneous embolization on the parent artery of the proximal and distal ends of aneurismal cavity opening and a placement of BMS in the aneurismal cavity. One patient with true SAA underwent successful embolization using coaxial microcatheter combined with detachable coils in the balloon due to parent artery twist and large opening of SAA. Fourteen patients received postoperative subcutaneous injection of low molecular weight heparin till discharge without digestive tract symptoms such as nausea and vomiting. The results of followup: 1 patient was complicated with splenic infarction, 3 with temporary abdominal pains and low fever and other patients with good recovery and without recurrence and enlargement of aneurismal cavity at postoperative month 1. No assistedstent displacement of 2 patients and no adverse reaction occurred at postoperative month 6.
Conclusions: Interventional therapy of SAA is feasible, safe and effective, with the advantages of faster recovery of patients, less complications, preservation of the spleen function and a good application value.