Technical and clinical outcomes of endovascular treatment for splenic artery aneurysms
摘要
This study aimed to evaluate the outcomes of endovascular treatment for splenic artery aneurysms (SAAs).
MethodsA retrospective review was conducted of patients with SAAs who underwent endovascular treatment between January 2019 and June 2024. Patient demographics, aneurysm characteristics, treatment strategies, and perioperative and long-term outcomes were analyzed.
ResultsA total of 19 patients with SAAs, with a median age of 53 years (IQR 47–57 years), were treated endovascularly. Of these, 15 patients were treated with embolization alone, and 4 with covered stent placement. Technical success, defined as successful deployment of devices and complete exclusion of the aneurysm on final angiography, was achieved in 18 out of 19 patients (94.74%). The mean contrast medium volume used was 88.5 ± 9.5 mL, and the median operative time was 84 min (IQR 65–105 min). Post-embolization syndrome (PES) occurred in 15.79% (3/19) of patients. One patient developed splenic artery dissection, and 47.37% (9/19) had splenic infarction. During a median clinical follow-up of 35.5 months (IQR 11.25–45.5 months), there was no mortality, no hepatic or intestinal ischemia, or need for reintervention in either the perioperative period or during follow-up. The median duration of CT imaging follow-up was 28 months (IQR 10.5–35.5 months). The median aneurysm diameter was 25 mm (IQR 19.5–30.6 mm) before treatment and decreased to 19.9 mm (IQR 16.9–24.8 mm) on the last follow-up CT scan (P = 0.130). Among the nine patients with splenic infarction, follow-up imaging revealed complete resolution of the infarcted area in four cases and a marked reduction in infarct size in the remaining five. One patient with a minor endoleak and a stable aneurysm was managed conservatively. The vast majority of aneurysms (94.74%, 18/19) were completely excluded and had achieved complete thrombosis. Univariate regression analyses found no significant association between spleen diameter and complete aneurysm thrombosis (P = 0.999) or the degree of aneurysm sac shrinkage (P = 0.297).
ConclusionBased on our single-center experience, endovascular techniques appear to be feasible, safe, and effective for treating SAAs, with appropriate intervention tailored to anatomical location and aneurysm characteristics.