Common Visceral Aneurysm Research Articles

The natural history and long-term follow-up of splenic artery aneurysms

ObjectiveAlthough splenic artery aneurysms (SAAs) are the most common visceral aneurysm, there is a paucity of literature on the behavior of these entities. The objective of this study was to review the natural history of patients with SAA. MethodsThis single-institution, retrospective analysis studied patients with SAA diagnosed by computed tomography imaging between 2015 and 2019, identified by our institutional radiology database. Imaging, demographic, and clinical data were obtained via the electronic medical record. The growth rate was calculated for patients with radiologic follow-up. ResultsThe cohort consisted of 853 patients with 890 SAAs, of whom 692 were female (81.2%). There were 37 women (5.3%) of childbearing age (15-50 years). The mean age at diagnosis was 70.9 years (range: 28-100 years). Frequently observed medical comorbidities included hypertension (70.2%), hypercholesterolemia (54.7%), and prior smoking (32.2%). Imaging indications included abdominal pain (37.3%), unrelated follow-up (28.0%), and follow-up of a previously noted visceral artery aneurysm (8.6%). The mean diameter at diagnosis was 13.3 ± 6.3 mm. Anatomic locations included the splenic hilum (36.0%), distal splenic artery (30.3%), midsplenic artery (23.9%), and proximal splenic artery (9.7%). Radiographically, the majority were saccular aneurysms (72.4%) with calcifications (88.5%). One patient (38-year-old woman) was initially diagnosed at the time of rupture of a 25 mm aneurysm; this patient underwent immediate endovascular intervention with no complications. The mean clinical follow-up among 812 patients was 4.1 ± 4.0 years, and the mean radiological follow-up among 514 patients was 3.8 ± 6.8 years. Of the latter, 122 patients (23.7%) experienced growth. Aneurysm growth rates for initial sizes <10 mm (n = 123), 10 to 19 mm (n = 353), 20 to 29 mm (n = 34), and >30 mm (n = 4) were 0.166 mm/y, 0.172 mm/y, 0.383 mm/y, and 0.246 mm/y, respectively. Of the entire cohort, 27 patients (3.2%) eventually underwent intervention (81.5% endovascular), with the most common indications including size/growth criteria (70.4%) and symptom development (18.5%). On multivariate analysis, only prior tobacco use was significantly associated with aneurysm growth (P = .028). ConclusionsThe majority of SAAs in this cohort remained stable in size, with few patients requiring intervention over a mean follow-up of 4 years. Current guidelines recommending treatment of asymptomatic aneurysms >30 mm appear appropriate given their slow progression. Despite societal recommendations for intervention for all SAAs among women of childbearing age, only a minority underwent vascular surgical consultation and intervention in this series, indicating that these recommendations are likely not well known in the general medical community.

CASE REPORT: HEPATIC ARTERY ANEURYSM.A RARE VISCERAL ANEURYSM

Hepatic artery aneurysm (HAA) is a rare disease (0.002%– 0.4%) but is a clinically important phenomenon [1]. HAAs are traditionally the second most common visceral aneurysms with an incidence of 20% and have the highest (44%) reported rate of rupture [2]. The clinical manifestations depending on the size of the aneurysm include epigastric pain, obstruction of biliary tract, rupture and death [3]. Imaging modalities like computed tomography (CT) and CT angiography have a valuable role in the early detection of HHA, its complications, and selecting appropriate treatments depending on the size and location of the aneurysms [4].The etiology of visceral artery aneurysms is mostly atherosclerotic. Trauma and inflammation may cause pseudoaneurysm formation, such as in case of an acute pancreatitis causing periarterial inflammation or vessel erosion from an adjacent pseudocyst[5,6]. Other conditions which are associated with hepatic artery aneurysms are medial degeneration, fibromuscular dysplasia and vasculitis [7]. Atherosclerotic aneurysms are typically extrahepatic while traumatic aneurysms or pseudoaneurysms are more commonly intrahepatic [8].

Giant aneurysm of the splenic artery

Splenic artery aneurysms (SAA) are one of the common visceral aneurysms. However giant SAA have barely been reported. We discuss a case of SAA, who had prior history of caroli disease at the stage of secondary biliary cirrhosis for which he was a candidate for liver transplantation. The patient underwent open surgical repair. The proximal and distal spenic artery were ligated from within the aneurysm and surgery was completed with splenectomy. The post operative period was uneventful.&#x0D; Bang Med J Khulna 2021; 54 : 26-27

ANEURYSM OF SPLENIC ARTERY. INCIDENCE, CLINIC, DIAGNOSIS, TREATMENT. REVIEW AND CASES FROM PRACTICE

Aneurysms of splenic artery are the most common visceral aneurysms. There are true aneurysms and pseudoaneurysms. True aneurysms develop against the background of artery wall weakness. Pseudoaneurysms result from a rupture of the intima of the vessel wall with subsequent dissection of blood into a false lumen and formation of a periarterial hematoma. They are detected as an incidental finding without any clinical manifestation. The aim of this article is to present two clinical cases of a ruptured aneurysm of the splenic artery in our practice. The mortality rate after rupture of the splenic artery aneurysm varies from 25% to 40%. Under emergency conditions, the time for diagnosis is scarce and limited by the hemodynamic status of the patient. With increasing the possibilities of diagnostic imaging, the chances for minimally invasive treatment of incidentally detected pseudoaneurysms of the splenic artery improve. The conditions for successful management of this pathology include organization of emergency surgical care and collaboration between surgical teams.

3D printing in the preoperative planning and endovascular treatment of splenic artery aneurysm. Own clinical experience and literature review.

Splenic artery aneurysms (SAAs) are the most common visceral aneurysms. Endovascular treatment of SAAs is increasingly used. Appropriate preoperative imaging of aneurysms is crucial to treatment planning. The case of a patient with accidentally detected SAA on angio-CT examination was the basis for implementation of 3D printing to prepare an artery model. The 3D model made it easier to qualify for endovascular treatment of the SAA and helped to visualize its morphology. An excellent treatment effect was achieved. 3D printing provides an opportunity for better visualization of SAA anatomy, which has a direct impact on the choice of minimally invasive treatment method.

How to provide vascular control of splenic artery aneurysms? A case series

BackgroundSpleen artery aneurysm represents the most common visceral aneurysm and the third most common splanchnic aneurysm. Most patients have no symptoms and are diagnosed as a part of other diagnostic focuses and examinations. Greater prevalence and application of modern diagnostic and imaging procedures has resulted in greater detection of this disease. ResultsWe present two patients with splenic artery aneurysms localized in the splenic hilum, who auspiciously underwent laparoscopic splenectomies with the use of hem-o-lock clips in the vascular hilum without complications. Both postoperative courses were uneventful. At six months follow up, both patients are asymptomatic. ConclusionThese two cases showed that in addition to the numerous advantages of minimally invasive approaches for treating splenic arterial aneurysms, there is a possibility to improve laparoscopic technique in terms of safety and economic reasons by using hem - o - lock clips as a hemostatic technique for the vascular elements of the spleen hilum.

Hilar Spleen Artery Aneurysm—a Strong Indication for Laparoscopic Splenectomy: a Case Report and Literature Review

Spleen artery aneurysm represents the most common visceral aneurysm and the third most common splanchnic aneurysm. Most patients have no symptoms and are diagnosed as a part of other diagnostic focuses and examinations. In our study, we present a patient who, due to a spleen artery aneurysm localized in the spleen hilum, underwent laparoscopic splenectomy safely and effectively, without complications, with the use of hem-o-lok clips as a hemostatic technique for vascular elements of the spleen hilum. Our cases show that in addition to numerous advantages of the minimally invasive approach, there is the possibility to improve the laparoscopic technique in terms of safety and economic reasons by using hem-o-lok clips as a hemostatic technique for the vascular elements of the spleen hilum.

Laparoscopic splenectomy in the treatment of splenic artery aneurysm - case report and literature review

Introduction. Splenic artery aneurysm is the most common visceral aneurysm with a prevalence of 0.2?10%. It is the third most frequent abdominal aneurysm as well. It can be true or false. It occurs more often in women than in men. We present our experience with a 34-year-old female patient who underwent laparoscopic splenectomy due to the splenic aneurysm located in the splenic hilum. Case outline. We present a case of a 34-year-old female patient diagnosed with an enlarged splenic artery during a routine abdominal ultrasound examination. Abdominal scan and computed tomography angiography showed saccular aneurysm of the splenic artery located in the hilum of the spleen, 24 ? 17 mm in size. Given the good general condition and age of the patient, we decided to perform laparoscopic splenectomy. The operation was performed without complications, which was also the case with the postoperative flow. The patient was discharged from the hospital on the third postoperative day. Conclusion. Laparoscopic splenectomy is a safe and effective modality for the treatment of splenic artery aneurysm, localized in the splenic hilum. Considering all the benefits of minimally invasive surgery, laparoscopic splenectomy should be the treatment of choice, over the classical open approach.

1:45 PM, Abstract No. 42 - Splenic artery aneurysms: a retrospective review at Kaiser Permanente

Purpose: Splenic artery aneurysms are the most common visceral aneurysms. While their incidence has grown with increased use of cross-sectional imaging, little is known about the natural history of these lesions. We sought to investigate patient characteristics, clinical risk factors, and growth patterns of splenic artery aneurysms in a large patient cohort. Materials and Methods: A patient list was retrieved from all Kaiser Permanente sites in Southern California via query of the electronic medical records system for the ICD9 code 442.83 (splenic artery aneurysm). Patient charts were retrospectively reviewed and demographics and medical comorbidities documented for each case. Cases of splenic pseudoaneurysm were excluded. Image reports were reviewed to find the oldest and most recent imaging in which the lesion was noted and the size was recorded for each. The patient chart was also reviewed for interventions in the form of open surgical or IR procedures. Results: 569 patient with splenic artery aneurysms were identified with females accounting for 78% (n1⁄4442) of cases. The mean number of pregnancies in the 221 women with a documented obstetrics history was 3.9. The largest proportion of patients were White (69.1%), followed by Hispanic (22.5%), Asian (4.5%), and African American (3.8%). Current or former smokers made up 43.5% of all patients. The most frequent comorbidities in patients with splenic artery aneurysms were hypertension (67.4%), hyperlipidemia (55.9%), obesity (28.9%), diabetes mellitus (27.6%), atherosclerosis (25.3%), and liver cirrhosis (7.9%). 60 patients underwent a therapeutic procedure for their aneurysm including 39 with IR (primarily coil embolization), 18 with surgery, and 3 requiring both surgical and IR management. Longitudinal imaging data were available for 277 patients. 179 (65%) of these patients had aneurysms that were stable or decreased in maximum dimension. In the 98 patients who experienced interval aneurysm growth, the average growth rate was 0.95 mm/year. Conclusion: The preliminary results from our patient cohort represent the largest retrospective review of splenic artery aneurysms and aid in better defining the patient risk factors and natural history of these lesions.

Hepatic Artery Aneurysm: A Case Study

Hepatic artery aneurysms are very uncommon, with an estimated incidence of less than 0.25%. Most patients are asymptomatic and because of the tendency to rupture with potential catastrophic hemorrhage and liver ischemia, early diagnosis is important. Hepatic artery aneurysms are the second most common visceral aneurysms, representing 20% of visceral aneurysms.

Double Catheter Technique: A New Approach for Treatment of Anatomically Challenging Splenic Artery Aneurysm : A Case Report

Splenic artery aneurysms are the most common visceral aneurysm. They are usually asymptomatic, but may present rarely as abdominal pain, or with symptoms and signs of acute rupture. This is a case report of a 42 years old female patient who presented with mild abdominal pain and was found to have a splenic artery aneurysm with a challenging anatomy of the prominent splenic artery. The patient refused the surgical option of treatment, and was treated by endovascular embolization, using a double catheter technique.

Anomalous splenic artery aneurysm

Aneurysms of the splenic artery are the most common visceral aneurysm. A splenomesenteric trunk, which involves the splenic artery arising from the superior mesenteric artery (SMA), is rare and occurs in less than 1% of patients. Thus splenic artery aneurysms (SAAs) with an anomalous origin from the SMA are quite rare. We report our experience with the surgical management of a 2.6-cm aneurysm involving a splenic artery arising from the SMA in a 40-year-old woman. This was treated with surgical resection with preservation of the spleen. A discussion about SAAs and the management of aneurysms arising from a splenomesenteric trunk follows.

Anomalous splenic artery aneurysm.

Aneurysms of the splenic artery are the most common visceral aneurysm. A splenomesenteric trunk, which involves the splenic artery arising from the superior mesenteric artery (SMA), is rare and occurs in less than 1% of patients. Thus splenic artery aneurysms (SAAs) with an anomalous origin from the SMA are quite rare. We report our experience with the surgical management of a 2.6-cm aneurysm involving a splenic artery arising from the SMA in a 40-year-old woman. This was treated with surgical resection with preservation of the spleen. A discussion about SAAs and the management of aneurysms arising from a splenomesenteric trunk follows.

Spontaneous Rupture of a Saccular Intrahepatic Artery Aneurysm

Hepatic artery aneurysms are the second most common visceral aneurysm but are still relatively uncommon. Over the last century, methods for treating these lesions have evolved substantially. The presented case covers the presentation, diagnosis, and treatment of a 65-year-old woman with an aneurysm of the intrahepatic portion of the hepatic artery. This case demonstrates the variety of techniques available for managing these lesions and the importance of both a thorough knowledge of the available treatments and the flexibility to switch among them when necessary.

Splenic Artery Aneurysm Presenting as Extrahepatic Portal Vein Obstruction: A Case Report

Splenic artery aneurysms are the most common visceral aneurysm occuring predominantly in females. They are usually asymptomatic, and the symptomatic presentation includes chronic abdominal pain of varied severity or an acute rupture with hypotension. Splenic artery aneurysm causing extrahepatic portal hypertension is very rare and is due to splenic vein thrombosis that develops secondary to compression by the aneurysm. We report one such rare presentation of splenic artery aneurysms in a pregnant female with the features of EHPVO (variceal bleed, hypersplenism) treated by splenectomy along with excision of the aneurysm.

Hepatic Artery Aneurysm Erosion into the Stomach: An Unusual Cause of Gastrointestinal Bleeding

Hepatic artery aneurysms are the second most common visceral aneurysms. The natural history of hepatic artery aneurysms typically results in enlargement, rupture, and life-threatening hemorrhage. Atherosclerosis, traditionally, has been the most common cause of hepatic artery aneurysm. A case of a hepatic artery aneurysm invading the stomach is presented to draw attention to the clinical presentation of this potentially catastrophic entity. A 74-year-old man presented to the Emergency Department (ED) with hematemesis. He was hemodynamically stable with a hemoglobin of 10.5. Abdominal CT imaging revealed a hepatic artery aneurysm that eroded into the stomach. The erosion was successfully repaired operatively and the aneurysm was embolized. The most common symptom is epigastric pain. The clinical and radiological findings of a hepatic artery aneurysm eroding into the stomach with subsequent upper and lower gastrointestinal hemorrhage, as highlighted in the case reported, have received little prior attention in the medical literature.

Trans-catheter Thrombin Occlusion of a Massive Splenic Artery Aneurysm

Splenic artery aneurysms are the most common visceral aneurysm. They are treated by surgical or endovascular techniques and more recently by embolization. This short report describes the use of trans-catheter thrombin embolization to treat a very large volume splenic artery aneurysm.

Trans-catheter Thrombin Occlusion of a Massive Splenic Artery Aneurysm

Splenic artery aneurysms are the most common visceral aneurysm. They are treated by surgical or endovascular techniques and more recently by embolization. This short report describes the use of trans-catheter thrombin embolization to treat a very large volume splenic artery aneurysm.

Giant splenic artery aneurysms: Case report and review of the literature

Although splenic artery aneurysms (SAAs) are the most common visceral aneurysms, giant SAAs >10 cm in diameter have rarely been reported. We present the case of a 67-year-old asymptomatic man who was diagnosed with a 15-cm SAA in the absence of a clear etiologic factor. The patient underwent open surgical repair. A medial visceral rotation was performed to gain good vascular control and subsequently the aneurysm was ligated from within. A systematic review was carried out, allowing us to analyze 12 cases of giant SAAs >10 cm published to date. The difference in terms of demographics, clinical presentation, and arterial location between the giant SAA group and usual SAAs may indicate a different underlying physiopathology that remains unclear at this time.