Erschienen in:
01.06.2003 | Clinical Investigations
Management of Splenic Artery Aneurysms and False Aneurysms with
Endovascular Treatment in 12 Patients
verfasst von:
R. Guillon, J.M. Garcier, A. Abergel, R. Mofid, V. Garcia, T. Chahid, A. Ravel, D. Pezet, L. Boyer
Erschienen in:
CardioVascular and Interventional Radiology
|
Ausgabe 3/2003
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Abstract
Purpose: To assess the endovascular
treatment of splenic artery aneurysms and false aneurysms.
Methods: Twelve patients (mean age 59 years, range 47–75
years) with splenic artery aneurysm (n = 10) or false
aneurysm (n = 2) were treated. The lesion was
asymptomatic in 11 patients; hemobilia was observed in one patient. The
lesion was juxta-ostial in one case, located on the intermediate
segment of the splenic artery in four, near the splenic hilus in six,
and affected the whole length of the artery in one patient. In 10
cases, the maximum lesion diameter was greater than 2 cm; in one case
30% growth of an aneurysm 18 mm in diameter had occurred in 6 months;
in the last case, two distal aneurysms were associated (17 and 18 mm in
diameter). In one case, stent-grafting was attempted; one detachable
balloon occlusion was performed; the 10 other patients were treated
with coils.
Results: Endovascular treatment was possible
in 11 patients (92%) (one failure: stenting attempt). In four cases
among 11, the initial treatment was not successful (residual perfusion
of aneurysm); surgical treatment was carried out in one case, and a
second embolization in two. Thus in nine cases (75%) endovascular
treatment was successful: complete and persistent exclusion of the
aneurysm but with spleen perfusion persisting at the end of follow-up
on CT scans (mean 13 months). An early and transient elevation of
pancreatic enzymes was observed in four cases.
Conclusion: Ultrasound and CT have made the diagnosis of
splenic artery aneurysm or false aneurysm more frequent. Endovascular
treatment, the morbidity of which is low, is effective and spares the
spleen.