Clinical Scenario

This protocol addresses the management of an unruptured splenic artery aneurysm that is saccular in morphology with a narrow neck, defined by a neck-to-aneurysm width ratio of less than 0.5. This anatomical configuration — sometimes classified as a Type I aneurysm — is relevant to the selection of the appropriate endovascular technique.

Treatment Approach (Partial Overview)

The recommended approach is endovascular, centred on embolization of the aneurysm sac. An alternative embolization strategy may be applicable depending on anatomical considerations. The complete procedural algorithm, technique selection criteria, and intraprocedural management are available in the full protocol.

Treatment Goal

Complete exclusion of the splenic artery aneurysm, confirmed by immediate postoperative angiography.

References

DOI: 10.1016/j.jvs.2024.05.030

Type I aneurysms are defined as saccular with a narrow neck, characterized by a neck-to-aneurysm width ratio of <0.5.
Owing to its low risk of coil migration, sac coil packing was recommended as first choice of treatment.
In addition, isolation embolization with or without sac coil packing is considered viable when collateral flow to the spleen is sufficient.
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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Treatment of Unruptured Splenic Artery Aneurysm — Saccular Type with a Narrow Neck (Neck-to-Aneurysm Ratio <0.5)

References