Ruptured splenic artery aneurysm carries a high risk of hemorrhage and significant mortality. Intervention must begin as soon as the diagnosis is confirmed — the approach and critical technical requirements are determined by the specifics of each case.
Either endovascular or open surgical intervention is indicated. The selection between these options, and the specific technical requirements that must be satisfied to achieve a successful outcome, are set out in full in the structured protocol.
The primary endpoint is:
Complete exclusion of the splenic artery aneurysm confirmed on immediate postoperative angiographyDOI: 10.1016/j.jvs.2024.05.030
Owing to the high risk of hemorrhage and significant mortality risk in type V SAAs, we recommend performing endovascular or surgical treatment as soon as possible once diagnosed.
If the patient's condition is stable, an initial attempt at endovascular therapy like splenic artery embolization, as demonstrated by two cases in this study, is feasible.
In addition, sac coil packing alone without parent artery occlusion is not recommended, because it poses a high risk of rupture in some aneurysm cases, such as pseudoaneurysms.
Complete exclusion of the aneurysm is crucial for treating this type of SAAs; endovascular splenic artery embolization or surgical approaches include SAA resection and ligation, with or without splenectomy.
View source ↗