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
Etiology
- Degenerative from underlying medial fibrodysplasia (atherosclerosis not considered to be the primary etiology)
- Inflammatory: almost always related to pancreatitis and pseudocysts
- Posttraumatic
- Pregnancy related: high association with mortality for mother and fetus with ruptured aneurysms
Treatment
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
Reference:
Kandarpa K. Peripheral Vascular Intervention. Lippincott Williams & Wilkins, 1st edition (October 1, 2007).
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