Safety and effectiveness of endovascular treatment of splenic artery aneurysms: a single centre experience

Abstract

Purpose: The aim of the study was to analyse the safety and effectiveness of endovascular treatment of splenic artery aneurysms (SAAs), and thereby complement the limited number of publications on this topic in the current literature. Methods: Twenty-three patients who underwent endovascular treatment for true splenic aneurysm or pseudoaneurysm at our centre between March 2010 and December 2024 were retrospectively included in the study. Data collection and analysis included technical and clinical success, adverse events, as well as mortality and follow up data. Results: 21 true SAAs and two pseudoaneurysms with a mean diameter of 2.56 ± 0.81 cm (range, 2.0–4.0 cm) were included in the study. One SAA was treated with covered stent implantation, nine with sac embolization, and 13 with intra-aneurysm and aneurysm-bearing artery coil embolization. The technical success rate was 100%. The clinical success rate was 91.30%, defined as persistent aneurysm exclusion and preservation of at least 50% splenic perfusion. Mild adverse events occurred in 34.78% of patients, including post-embolization syndrome (21.74%) and small splenic infarctions (13.04%). One patient experienced post-embolization pancreatitis (4.35%). Severe adverse events (8.70%) included two splenectomies due to a splenic abscess and gastric bleeding caused by coil migration. No deaths occurred during the study period. Conclusion: Endovascular treatment is an effective, minimally invasive alternative to open surgery for splenic artery aneurysms, achieving high success rates and satisfactory follow-up outcomes when the appropriate method is chosen—both for asymptomatic SAAs and hemodynamically stable patients with ruptured SAAs or pseudoaneurysms.