Coil Embolization of Splenic Artery Aneurysms: Results and Review

OBJECTIVES: To review and evaluate coil embolization for the treatment of splenic artery aneurysms (SAAs) at a tertiary-care institution and compare these results to a comprehensive literature review.
METHODS: Patients with SAA were identified by query of a prospectively maintained vascular surgery database. A 5-year retrospective chart review was performed with basic demographics, peri-procedural details, and outcomes determined. Ruptures, pseudoaneurysms, and mycotic aneurysms were excluded. Literature review with similar parameters was performed.
RESULTS: From 7/2002 to 7/2007, 5 patients were identified with SAA of which all were treated with coil embolization. Three patients were female (2 pre-menopausal) and 2 were male. Mean age was 52 years (range 32 - 74). One female with a remote history of liver transplant failed initial deployment with a covered stent. Mean aneurysm size was 2.7 cm (range 2 -3) and one patient had two aneurysms. Catheter access utilized the femoral artery in 3 patients, axillary in 1 and brachial in 1. Mean numbers of coils was 16 (range 7 - 29). No patients developed signs or symptoms of splenic infarct and all were discharged the following day. Follow-up by duplex/cat scan in 1 - 3 months demonstrated 2 SAAs thrombosed with splenic artery patency and 3 SAAs thrombosed with splenic artery thrombosis. Eighty-seven patients were identified in the literature with a 92% success rate of coil embolization.
CONCLUSIONS: Coil embolization represents a safe, effective, and durable means for treatment of intermediate size SAAs. The large majority of patients presenting with SAA can be treated by this technique.