This protocol addresses a specific anatomical subtype of unruptured splenic artery aneurysm: one situated at the opening (ostium) of the splenic artery, or where the splenic artery arises aberrantly from the superior mesenteric artery. This anatomical position defines a distinct presentation with dedicated interventional considerations.
This subtype — classified as a Type IVa splenic artery aneurysm — is defined by its location at the opening of the splenic artery, or by an aberrant splenic artery originating from the superior mesenteric artery (SMA). The origin point of the aneurysm directly shapes the technical approach to intervention.
An endovascular strategy involving dense packing of the aneurysm sac is applied in this anatomical setting. The complete procedural technique, sequence, and periprocedural considerations are detailed in the full protocol.
Complete exclusion of the splenic artery aneurysm, confirmed on immediate postoperative angiography.
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.
Therefore, dense packing of the aneurysm sac is considered a more rational approach.
View source ↗