September 24, 2009

Splenic Artery Aneurysm

Figures 1&2: Axial contrast-enhanced CT images (2nd image is a maximum-intensity projection image) show a 2-cm saccular aneurysm (arrows) of the mid splenic artery in a 38-year-old woman with idiopathic hepatic cirrhosis, portal hypertension and splenomegaly. CA = celiac artery

Facts About Splenic Artery Aneurysm
  • Most common visceral artery aneurysm
  • Incidence up to 7% in autopsy series, nearly 1% on abdominal angiographic series
  • Most are saccular
  • Most are in mid or distal splenic artery
  • Women > men
  1. Degenerative from underlying medial fibrodysplasia (atherosclerosis not considered to be the primary etiology)
  2. Inflammatory: almost always related to pancreatitis and pseudocysts
  3. Posttraumatic
  4. Pregnancy related: high association with mortality for mother and fetus with ruptured aneurysms
Most surgical literature recommends repair if
  • Larger than 2 cm
  • Enlarging on follow ups
  • Pregnant patients or in women of childbearing age who might become pregnant
Open repair or endovascular therapy

Kandarpa K. Peripheral Vascular Intervention. Lippincott Williams & Wilkins, 1st edition (October 1, 2007).

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