Treatment of Unruptured Splenic Artery Aneurysm in Giant SAA (Diameter >5 cm)
Clinical Scenario
This protocol addresses unruptured splenic artery aneurysm presenting as a giant splenic artery aneurysm (GSAA) — defined by an aneurysm diameter exceeding 5 cm. This corresponds to a type IVb classification, a high-risk anatomical subset that represents a clear indication for definitive intervention.
Treatment Approach
The standard approach involves open surgical intervention targeted at the aneurysm. The specific operative strategy — including procedure selection and management of adjacent structures — is outlined in the full structured protocol.
Complete regimen, criteria, and decision algorithm are available via the link below.
Treatment Goal
The target outcome is complete occlusion or resection of the splenic artery aneurysm, confirmed under direct visualization.
References
DOI: 10.1016/j.jvs.2024.05.030
- Type IVa is located at the opening of the splenic artery or an aberrant splenic artery originating from the superior mesenteric artery (SMA), type IVb is a giant SAA (GSAA) defined by an aneurysm diameter of >5 cm, and type IVc is characterized by severe tortuosity or tandem aneurysms of the main splenic artery.
- Open surgery is generally regarded as the optimal treatment, although there are reported cases where embolization yielded satisfactory outcomes.
- Hamid et al performed a systematic review of 92 GSAA cases, indicated that surgical treatment remains the standard approach at present.
- Technical success was defined as complete exclusion of the aneurysm via immediate postoperative angiography and complete occlusion or resection of the aneurysm under endoscopy or direct visualization.
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