Transcatheter Embolization of Multiple Mycotic Splenic Artery Aneurysms: A Case Report

Abstract

Embolization of splenic artery aneurysms is recommended in young women to prevent likely rupture and exsanguination during pregnancy. This report describes the successful coil occlusion of multiple mycotic aneurysms in such a patient, who was also treated interventionally for gastric hemorrhage and hypersplenism. Although infection or sepsis is a rare cause of visceral aneurysms, it is associated with a high incidence of rupture and peritonitis. Complications from elective embolization include abscess formation within the spleen and focal infarction in the upper alimentary tract. However, such risks should be minimized by appropriate selection of embolic materials and prophylactic care of the patient.

Laparoscopic Splenic Artery Aneurysm Resection

“…1,2,6,8,9,11 It is usually saccular, 75% are located in the distal third of splenic artery (especially at the bifurcation point), followed by 20% in the middle third. 1,2,6,8,9,11 Many are calcified owing to increased turbulence but this does not protect against rupture. 1,11,13 With rupture, there may be abdominal, chest, or flank pain, which may radiate to the back, associated occasionally with Kher sign, and hemodynamic instability.…”

“…1,13 Complications The main and most serious complication is rupture, and the reported risk is 2% to 10%. 1,2,4,[6][7][8]10 It is increased to 76% to 83% in symptomatic patients. 9 The estimated mortality rate has been observed to be between 10% and 76% and up to 90%.…”

“…2 Conventional angiography is the most valuable tool for diagnosis, localization, assessment of other lesions, and collateral flows. 6,9 Indications for Treatment Most authors choose 2 cm as the cut-off size for intervention, whereas some have proposed 1.5 and 3 cm.…”

“…[1][2][3][4] It has been reported to occur in 0.02% to 10.4% of the population and accounts for 60% to 71% of visceral aneurysms. [1][2][3][5][6][7][8][9][10][11][12] It is third commonest among the intra-abdominal aneurysms.…”

“…[1][2][3][4] It has been reported to occur in 0.02% to 10.4% of the population and accounts for 60% to 71% of visceral aneurysms. [1][2][3][5][6][7][8][9][10][11][12] It is third commonest among the intra-abdominal aneurysms. [1][2][3][5][6][7][8][9][10][11][12] Although rare, they are increasingly demonstrated with advances in imaging techniques.…”