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Splenic artery aneurysm: Management of a rare entity in a series of patients

Server Sezgin Uludag, Deniz Esin Tekcan Sanli, Nazım Gures, Ahmet Necati Sanli, Berk Arapi, Sabri Sirolu, Fatih Gulsen, Abdullah Kagan Zengin.




Abstract

Splenic artery aneurysm (SAA) is a rare clinical condition; however, it can lead to life-threatening hemorrhages. Endoscopic and endovascular treatments or laparoscopic and open surgical approaches can be used for the treatment. On the grounds of its rarity, there are few series in the literature. We aimed to present our center’s experience of splenic artery aneurysm management. Patients' data who were treated in our hospital between 2008 and 2019 due to splenic artery aneurysm was retrieved from the hospital’s registry software. Patients’ demographic data (age, gender); type, localization and the diameter of aneurysms and treatment methods applied were examined. There were 13 (10 females, 3 males) consecutive patients (mean age was 51.7±16.9 years) in the study. Aneurysms were located proximally in six patients, distally in six patients, and one patient had aneurysm both proximally and distally. Nine of the aneurysms were saccular and four were fusiform. Coil embolization was successful in one patient, splenic artery ligation was applied to six patients and splenectomy was performed in four patients. Two patients, in whom coil embolization failed, were included in the follow-up program since they were asymptomatic. Morbidity and/or mortality due to aneurysms were not seen in treated patients. Nowadays, endovascular interventions are the primary treatment option for SAAs. However, they do not apply to every patient and surgery may be necessary. While choosing the appropriate surgery, the primary goal should be minimally invasive procedures that require good laparoscopic experience. Isolated ligation of the splenic artery and protection of the spleen should be performed if possible.

Key words: Splenic artery aneurysm, coil embolization, endovascular intervention, minimally invasive procedure.






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