ORIGINAL ARTICLES   

International Angiology 2011 August;30(4):359-65

Copyright © 2011 EDIZIONI MINERVA MEDICA

lingua: Inglese

Long-term results of endovascular treatment for splenic artery aneurysms

Kagaya H. ¹, Miyata T. ¹, Hoshina K. ¹, Kimura H. ¹, Okamoto H. ¹, Shigematsu K. ¹, Akahane M. ², Na-gawa H. ¹ ✉

¹ Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan; ² Department of Radiology, University of Tokyo Hospital, Tokyo, Japan

AIM:The aim of this paper was to evaluate our single-center experience of the management of splenic artery aneurysm (SAA), with particular attention to the long-term results of endovascular treatment.
METHODS: Thirty-eight patients with the diagnosis of SAA at the Tokyo University Hospital during the past 23 years were retrospectively reviewed. Interventions were considered for patients with SAA>2 cm in diameter. Nine patients were treated by transcatheter embolization (TE), and 8 by open surgical repair (SR). Twenty-one patients were observed (OB). TE was performed with microcoils placed distal and proximal to the aneurysm in the afferent artery to isolate the aneurysm.
RESULTS: In the TE group, the primary technical success rate was 100%. No 30-day mortality or any catheter-related complication was observed. The median length of hospital stay after TE, excluding one patient who required further surgery, was shorter than that after SR (8 versus 16 days, P=0.001). During follow-up (median =45 months), no patient died and no recurrence of SAA was observed. In the SR group, all aneurysms were repaired successfully without any severe complication, and no aneurysm-related death occurred during follow-up (median =57 months). In the OB group, no aneurysm rupture or increase in aneurysm size was observed during follow-up (median =35 months).
CONCLUSION:TE provided good early and long-term results, comparable to those obtained with conventional SR. In addition, TE had several advantages associated with its minimal invasiveness. TE by the isolation technique could be the first-line strategy for all SAA requiring treatment.