Splenic artery aneurysms: post-embolization syndrome and surgical complications

Background
This study assessed the endovascular embolization of splenic artery aneurysms and false aneurysms with special consideration given to postoperative complications.

Methods
Fifteen patients (11 women; mean age, 56 y; range, 39–80 y) with splenic artery aneurysm (n = 13) or false aneurysm (n = 2) were treated with coil embolization. The lesion was asymptomatic in 9 patients, symptomatic in 5 patients, and ruptured in 1 patient. The mean aneurysm diameter was 33 ± 23 mm (range, 15–80 mm). Postoperative follow-up evaluation included a clinical visit and spiral computed tomography at 1, 4, and 12 months, and yearly thereafter.

Results
Endovascular treatment was possible in 14 patients (93%) (1 failure: neck cannulation). Perioperative mortality was not observed. Morbidity included postembolization syndrome in 5 patients (30%). Neither pancreatitis nor spleen abscess occurred. The mean follow-up period was 36 months (range, 3–60 mo). During follow-up evaluation we detected 1 sac reperfusion that was sealed successfully with additional coils. Surgical conversion or open repair were never required.

Conclusions
At our institute, endovascular treatment represents the first-line treatment for splenic artery aneurysms. Postembolization syndrome and infarcts are common events but generally resolve without sequelae.