Treatment of Wide-Necked Saccular or Fusiform Splenic Artery Aneurysm on the Main Trunk

Clinical scenario

This protocol applies to splenic artery aneurysms that are wide-necked — either saccular or fusiform — located on the main trunk of the splenic artery, with a landing zone of more than 1 cm available at both ends of the aneurysm and a neck-to-aneurysm width ratio greater than 0.5.

Why this subtype matters

The wide-neck morphology (neck-to-aneurysm width ratio >0.5) and main-trunk location define a distinct anatomical situation that determines which interventional approach is appropriate. The presence of an adequate landing zone at both ends is a key criterion that shapes the management strategy for this aneurysm type.

Treatment approach (partial overview)

When anatomical criteria are met, an endovascular covered-stent strategy is considered — designed to exclude the aneurysm while preserving forward flow in the splenic artery. Full procedural details, decision criteria, and intraprocedural management are in the structured protocol.

Complete regimen, technical specifications, and procedural sequence available via the protocol link below.

Treatment goal

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

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.jvs.2024.05.030

Type II aneurysms are wide necked, either saccular or fusiform, located on the main trunk of the splenic artery, with a landing zone at both ends of >1 cm; a wide neck is indicated by a neck-to-aneurysm width ratio of >0.5.

For type II aneurysms, covered stent implantation is recommended first when there is sufficient landing zone in its location.

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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