title: Endovascular Embolization of a Large High-Flow Splenic Arteriovenous Fistula and Aneurysm Using the Amplatzer Vascular Plug II.
abstract: We describe the use of an Amplatzer Vascular Plug (AVP) II for embolizing a large high-flow splenic arteriovenous fistula and an aneurysm in a young patient. This patient presented to our center with persistent mild abdominal discomfort, 5 years after open splenectomy. Contrast-enhanced computed tomography angiography showed the presence of a fistula between the splenic arterial and splenic venous remnants and a resultant fusiform aneurysmal dilatation of the residual splenic vein. We decide to embolize the splenic artery with a 12-mm diameter AVP II with an oversizing by 70% of the vessel diameter. Celiac angiography performed 5 min postembolization revealed complete obliteration of the splenic artery and closure of the arteriovenous fistula. The overall procedure time was 40 min, and overall radiation exposure was 32 Gy cm(2) (dose-area product).
authors.affiliation: Department of Diagnostic and Therapeutic Services, Radiology Service, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy; Department of Radiology, Di.Bi.Me.F., University of Palermo, Palermo, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: D'Amico
authors.affiliation: Department of Diagnostic and Therapeutic Services, Radiology Service, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy. Electronic address: rmiraglia@ismett.edu.
authors.forename: Roberto
authors.initials: R
authors.lastname: Miraglia
authors.affiliation: Department of Diagnostic and Therapeutic Services, Radiology Service, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy.
authors.forename: Settimo
authors.initials: S
authors.lastname: Caruso
authors.affiliation: Department of Diagnostic and Therapeutic Services, Radiology Service, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Maruzzelli
authors.affiliation: Department of Diagnostic and Therapeutic Services, Radiology Service, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy.
authors.forename: Kelvin
authors.initials: K
authors.lastname: Cortis
authors.affiliation: Department of Diagnostic and Therapeutic Services, Radiology Service, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Luca
mesh_terms: D000328:Adult; D000783:Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D015901:Angiography, Digital Subtraction; D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D001783:Blood Flow Velocity; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D005260:Female; D006801:Humans; D011829:Radiation Dosage; D000069079:Radiation Exposure; D012039:Regional Blood Flow; D013156:Splenectomy / Q000009:adverse effects*; D013157:Splenic Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013162:Splenic Vein / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome