Treatment of Unruptured Splenic Artery Aneurysm with Severe Tortuosity or Tandem Aneurysms

Managing a splenic artery aneurysm becomes anatomically complex when the vessel shows severe tortuosity or when multiple aneurysms occur in tandem along the main trunk. This specific configuration shapes the choice of intervention.

Clinical Scenario

This protocol applies to splenic artery aneurysms with severe tortuosity of the splenic artery, or tandem aneurysms along the main trunk of the splenic artery. These are recognised as a distinct anatomical subtype (type IVc), characterised by complex arterial geometry that limits the applicability of certain approaches.

Treatment Approach

A laparoscopic surgical approach is the primary option for this anatomical subtype. The procedure targets complete occlusion or resection of the aneurysm confirmed under direct visualisation.

The complete structured regimen — including procedural details, decision points, and specific technique selection — is available in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.jvs.2024.05.030

Type IVc SAAs are characterized by severe tortuosity or tandem aneurysms along the main trunk of the splenic artery, identifying them as a subtype of CSAAs.

For type IVc SAAs, we recommend laparoscopic surgery as the primary option.

Therefore, SAAs with severe tortuosity are not suitable for endovascular treatment, and laparoscopic SAA resection or ligation is an optimal option.

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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