This protocol applies to ruptured splenic artery aneurysm (SAA) in the specific situation where the initial endovascular approach did not deliver the required outcome on immediate assessment, or where hemodynamic collapse makes endovascular management untenable.
The preceding line — endovascular therapy via splenic artery embolization — did not achieve its required goal: complete exclusion of the splenic artery aneurysm on immediate postoperative angiography. Technical failure of the endovascular procedure, or hemodynamic collapse, triggers escalation to this next-line protocol.
When endovascular therapy fails or is not feasible, emergency surgical intervention is indicated. The approach utilises open or laparoscopic operative techniques to achieve complete aneurysm exclusion — the specific procedure selection and surgical decision algorithm are contained in the full protocol.
Complete exclusion of the splenic artery aneurysm.
DOI: 10.1016/j.jvs.2024.05.030
If endovascular therapy technical failure or hemodynamic collapse occur, an immediate conversion to emergency open or laparoscopic surgery is necessary.
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.
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