title: Transcatheter arterial embolization of splenic artery aneurysms and pseudoaneurysms: short- and long-term results.
abstract: We evaluated outcomes of endovascular treatment of splenic artery aneurysms and pseudoaneurysms. From April 2002 to May 2007, 17 patients (mean age 55.2 years, range 17-82) with splenic artery aneurysms (n = 7) or pseudoaneurysms (n = 10) underwent endovascular treatment. Six patients were asymptomatic, three had symptomatic nonruptured aneurysms, and eight had ruptured aneurysms. Lesions were in the proximal splenic artery (n = 5), intermediate splenic artery (n = 3), splenic hilum (n = 6), or parenchyma (n = 3). Embolization was with microcoils by sac packing (n = 8), sandwich occlusion of the main splenic artery (n = 4), or cyanoacrylate glue into the feeding artery (n = 4). Computed angiotomography was done within the first month and magnetic resonance angiography after 6 and 12 months, then yearly. Mean follow-up was 29 months (range 1-62). Exclusion of the aneurysm was achieved in 16 (94.1%) patients. One patient with an intraparenchymal pseudoaneurysm underwent splenectomy after failed distal catheterization. No major complications occurred. Postembolization syndrome developed in four patients, who had radiographic evidence of splenic microinfarcts. Transcatheter embolization of splenic artery aneurysms/pseudoaneurysms is safe and effective and may induce less morbidity than open surgery, in particular by preserving the spleen. Coil artifacts may make magnetic resonance angiography preferable over computed tomography for follow-up.
authors.affiliation: Department of Vascular and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, Dijon, France. loffroy.romaric@neuf.fr
authors.forename: Romaric
authors.initials: R
authors.lastname: Loffroy
authors.forename: Boris
authors.initials: B
authors.lastname: Guiu
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Cercueil
authors.forename: Côme
authors.initials: C
authors.lastname: Lepage
authors.forename: Nicolas
authors.initials: N
authors.lastname: Cheynel
authors.forename: Eric
authors.initials: E
authors.lastname: Steinmetz
authors.forename: Frédéric
authors.initials: F
authors.lastname: Ricolfi
authors.forename: Denis
authors.initials: D
authors.lastname: Krausé
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000473:pathology / Q000628:therapy*; D017541:Aneurysm, False / Q000473:pathology / Q000628:therapy*; D017542:Aneurysm, Ruptured / Q000473:pathology / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000009:adverse effects; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013157:Splenic Artery; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome