A Review of Management Options for Splenic Artery Aneurysms and Pseudoaneurysms

Overview

Journal Ann Med Surg (Lond)

Publisher Wolters Kluwer

Specialty Medical Education

Date 2020 Sep 28

PMID 32983447

Citations 5

Authors

Hse Juinn Lim

Affiliations

Soon will be listed here.

Abstract

Background: A review of the management of splenic artery aneurysms (SAA). There is no general consensus as to when and what type of intervention should be chosen to treat SAAs. The aim of this study is to investigate the types of intervention for SAAs including complication, reintervention, rupture, mortality after intervention of SAA in a review.

Method: A literature search was performed using "keywords" in Medline and Embase limited to publications from 2008 to 2018. 289 articles were identified during the initial literature search. 143 articles met the eligibility criteria. 83 articles were included in the quantitative synthesis. Descriptive analysis was performed.

Results: 576 patients were identified with 588 reported SAAs. The mean ± SD age was 52.6 ± 5.8 years (range 17-85). The mean ± SD size of SAA was 49.9 ± 13.2 mm (range 6-180). Types of intervention reported were endovascular treatment, open surgery, laparoscopic surgery and conservative management. Mortality rate in patients with endovascular treatment was 0.5% compared to 4.9% with open surgery. 3.4% of patients with conservative management were reported to have aneurysms that grew over time and 2.8% patients had further intervention. ANOVA test to compare mortality between open surgery, endovascular treatment and laparoscopic surgery showed there is no difference between mortality between the 3 different interventions as F (2.71) < F crit (3.02) (P = 0.07).

Conclusion: Endovascular treatment is now the first choice of treatment for SAA, but future studies are required to determine its long-term durability. By introducing a management pathway for SAA, we hope to see an improvement in managing patients. The management algorithm will require further validation through application with careful and complete follow-up of all cases to improve the pathway depending on patient outcome.

Citing Articles

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References

Sadat U, Dar O, Walsh S, Varty K . Splenic artery aneurysms in pregnancy--a systematic review. Int J Surg. 2007; 6(3):261-5. DOI: 10.1016/j.ijsu.2007.08.002. View

Antonopoulos C, Karagianni M, Galanakis N, Vagianos C . Mycotic splenic artery aneurysm secondary to Coxiella burnetii endocarditis. Ann Vasc Surg. 2009; 24(3):416.e13-6. DOI: 10.1016/j.avsg.2009.05.018. View

Ologun G, Sharpton K, Granet P . Successful use of resuscitative endovascular balloon occlusion of the aorta in the treatment of ruptured 8.5-cm splenic artery aneurysm. J Vasc Surg. 2017; 66(6):1873-1875. DOI: 10.1016/j.jvs.2017.05.138. View

Sawicki M, Marlicz W, Czapla N, Lokaj M, Skoczylas M, Donotek M . Massive Upper Gastrointestinal Bleeding from a Splenic Artery Pseudoaneurysm Caused by a Penetrating Gastric Ulcer: Case Report and Review of Literature. Pol J Radiol. 2015; 80:384-7. PMC: 4538884. DOI: 10.12659/PJR.894465. View

Pietrabissa A, Ferrari M, Berchiolli R, Morelli L, Pugliese L, Ferrari V . Laparoscopic treatment of splenic artery aneurysms. J Vasc Surg. 2009; 50(2):275-9. DOI: 10.1016/j.jvs.2009.03.015. View

Barisic T, Sutalo N, Letica L, Kordic A . Rupture of splenic artery aneurysm in primipara five days after cesarean section: case report and review of the literature. Wien Klin Wochenschr. 2015; 127(21-22):896-898. DOI: 10.1007/s00508-015-0856-x. View

Bae E, Vo T . Endovascular Repair of Concomitant Celiac and Splenic Artery Aneurysms Using a Combination of Coil Embolization and Aortic Cuff Stent Graft. Ann Vasc Surg. 2017; 42:62.e1-62.e4. DOI: 10.1016/j.avsg.2016.10.050. View

Akbulut S, Otan E . Management of Giant Splenic Artery Aneurysm: Comprehensive Literature Review. Medicine (Baltimore). 2015; 94(27):e1016. PMC: 4504560. DOI: 10.1097/MD.0000000000001016. View

Barbaros U, Ozemir I, Aksakal N, Tukenmez M, Kilic B, Agcaoglu O . Laparoscopic surgery of the splenic artery and vein aneurysm with spontaneous arteriovenous fistula. Surg Laparosc Endosc Percutan Tech. 2013; 23(3):e127-30. DOI: 10.1097/SLE.0b013e31827775f2. View

10.

Lo W, Mok K . Ruptured splenic artery aneurysm detected by emergency ultrasound-a case report. Crit Ultrasound J. 2015; 7(1):26. PMC: 4463952. DOI: 10.1186/s13089-015-0026-4. View

11.

Yamamoto S, Hirota S, Maeda H, Achiwa S, Arai K, Kobayashi K . Transcatheter coil embolization of splenic artery aneurysm. Cardiovasc Intervent Radiol. 2007; 31(3):527-34. DOI: 10.1007/s00270-007-9237-9. View

12.

Moon D, Lee S, Hwang S, Kim K, Ahn C, Ha T . Characteristics and management of splenic artery aneurysms in adult living donor liver transplant recipients. Liver Transpl. 2009; 15(11):1535-41. DOI: 10.1002/lt.21885. View

13.

Russo A, Francia C, Zaottini A, Pagliei M . Giant splenic artery aneurysm, incidentally diagnosed. Ann Ital Chir. 2009; 79(5):371-5. View

14.

Lakin R, Bena J, Sarac T, Shah S, Krajewski L, Srivastava S . The contemporary management of splenic artery aneurysms. J Vasc Surg. 2011; 53(4):958-64. DOI: 10.1016/j.jvs.2010.10.055. View

15.

Suarez Gonzalez L, Velasco M, Del Canto Peruyera P, Cervino Alvarez J, Alvarez Fernandez L . Images in vascular medicine. Endovascular treatment of a giant splenic aneurysm. Vasc Med. 2015; 20(6):571-2. DOI: 10.1177/1358863X15591202. View

16.

Goldberg R, Maley W, Kennedy E, Yeo C, Lavu H . Giant splenic artery pseudoaneurysm. J Gastrointest Surg. 2010; 15(6):1063-6. DOI: 10.1007/s11605-010-1388-3. View

17.

Corey M, Ergul E, Cambria R, English S, Patel V, Lancaster R . The natural history of splanchnic artery aneurysms and outcomes after operative intervention. J Vasc Surg. 2016; 63(4):949-57. DOI: 10.1016/j.jvs.2015.10.066. View

18.

Yadav S, Sharma P, Singh P, Punia S, Desai P, Anjan A . Giant splenic artery aneurysm: A rare but potentially catastrophic surgical challenge. Int J Surg Case Rep. 2012; 3(11):533-6. PMC: 3437397. DOI: 10.1016/j.ijscr.2012.06.010. View

19.

Pejkic S, Tomic I, Opacic D, Pejinovic L, Grubor N, Cinara I . Splenic Artery Aneurysms: Two Cases of Varied Etiology, Clinical Presentation and Treatment Outcome. Srp Arh Celok Lek. 2015; 143(5-6):326-31. DOI: 10.2298/sarh1506326p. View

20.

Yadav R, Tiwari M, Mathur R, Verma A . Unusually giant splenic artery and vein aneurysm with arteriovenous fistula with hypersplenism in a nulliparous woman. Interact Cardiovasc Thorac Surg. 2008; 8(3):384-6. DOI: 10.1510/icvts.2008.196121. View