Aneurysms of the splenic artery – A review

Al-Habbal, Yahya; Christophi, Christopher; Muralidharan, Vijayaragavan

doi:10.1016/j.surge.2009.11.011

Cited by 161 publications

(281 citation statements)

References 56 publications

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“…Indications for surgery were an aneurysm diameter C2 cm or \2 cm if in presence of diameter increase, saccular shape or child-bearing age, according to prevailing literature [1,5,6,[18][19][20][21], if the main trunk was involved. In the case of a hilar branches' aneurysm, in absence of clear guidelines, surgery was indicated for lesions exceeding 250 % of the caliber of the involved branch.…”

Section: Methodsmentioning

confidence: 99%

“…Endovascular stent grafts are indicated for proximally located aneurysms but long-term results remain unknown [18]. For these reasons, at our institution endovascular treatment is indicated in emergency situations or for critical patients not fit for surgery, while surgery is considered the best solution for patients requiring elective management of SAA.…”

Section: 3mentioning

confidence: 99%

“…Thus, laparoscopy may represent an interesting alternative to open surgery and provided that the same range of technical solutions offered by open surgery can be achieved with similar results [1,[14][15][16][17][18] and the general advantages of laparoscopy are confirmed in this specific application, the laparoscopic option may represent a challenging alternative not only to laparotomic surgery but also to endovascular procedures. Endovascular management, albeit minimally invasive, requires accurate patient selection and presents some Registration Number: NCT01387828.…”

Section: Introductionmentioning

confidence: 99%

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Prospective randomized comparison of open versus laparoscopic management of splenic artery aneurysms: a 10-year study

et al. 2012

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Background The literature does not support the choice between open and laparoscopic management of splenic artery aneurysms (SAA). Methods We designed a prospective, randomized comparison between open and laparoscopic surgery for SAA. Primary end points were types of surgical procedures performed and clinical outcomes. Analysis was developed on an intention-to-treat basis. Results Fourteen patients were allocated to laparotomy (group A) and 15 to laparoscopy (group B). Groups displayed similar patient-and aneurysm-related characteristics. The conversion rate to open surgery was 13.3 %. The type of surgical procedure performed on the splenic artery was similar in the two groups: aneurysmectomy with splenic artery ligature or direct anastomosis was performed in 51 % and 21 % of patients in group A and in 60 % and 20 % in group B, respectively. The splenectomy rate was similar (14 % vs. 20 %). Postoperative splenic infarction was observed in one case in each group. Laparoscopy was associated with shorter procedures (p = 0.0003) and lower morbidity (25 % vs. 64 %, p = 0.045). Major morbidity requiring interventional procedures and blood transfusion was observed only in group A. Laparoscopy was associated with quicker resumption of oral diet (p \ 0.001), earlier drain removal (p = 0.046), and shorter hospital stay (p \ 0.01). During a mean follow-up of 50 months, two patients in group A required hospital readmission. In group B, two patients developed a late thrombosis of arterial anastomoses. Conclusions Our study demonstrates that laparoscopy permits multiple technical options, does not increase the splenectomy rate, and reduces postoperative complications. It confirms the supposed clinical benefits of laparoscopy when ablative procedures are required but laparoscopic anastomoses show poor long-term results.Keywords Clinical paper Á Trials Á Splenic artery aneurysms Recent literature reports on the feasibility, safety, and effectiveness of laparoscopic management of splenic artery aneurysms (SAA) as well as its appreciation by patientsoften young females-who harbour the disease [1][2][3][4][5][6][7][8][9][10][11][12][13]. Thus, laparoscopy may represent an interesting alternative to open surgery and provided that the same range of technical solutions offered by open surgery can be achieved with similar results [1,[14][15][16][17][18] and the general advantages of laparoscopy are confirmed in this specific application, the laparoscopic option may represent a challenging alternative not only to laparotomic surgery but also to endovascular procedures. Endovascular management, albeit minimally invasive, requires accurate patient selection and presents some Registration Number: NCT01387828.

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Section: Methodsmentioning

confidence: 99%

Section: 3mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prospective randomized comparison of open versus laparoscopic management of splenic artery aneurysms: a 10-year study

et al. 2012

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“…A pseudoaneurysm or false aneurysm develops from a tear in the vessel wall with formation of arterial haematoma and is thought to be commonly due to local inflammation. [14] Splenic pseudoaneurysms are one of the complications of nonoperative management of blunt splenic trauma. The earliest retrospective study focussing on SAP looked at 298 patients who had a follow-up CT on day two or three and found 7.7% of patients developed SAP.…”

Section: Discussionmentioning

confidence: 99%

Delayed presentation of a traumatic splenic artery pseudoaneurysm in an initially normal spleen: Case study and review of literature

Dollie

2018

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Background: Blunt injury of the spleen is common and with the shift towards nonoperative management in haemodynamically stable patients, the delayed development of splenic artery pseudoaneurysms are of great concern. Management traditionally involves angioembolisation with the intent to preserve splenic function; however recent studies suggest that this is not without complication. Case presentation: We present a rare case of delayed splenic pseudoaneurysm arising 6 days post motorbike accident, with initial computerised tomography showing no evidence of splenic injury. The patient was successfully embolised and progressed well without complication. No clear cause was found for his development of splenic injury. Conclusions: Splenic artery pseudoaneurysms are not uncommon and necessitate follow-up imaging after nonoperative management of blunt splenic trauma. Once diagnosed, embolisation versus conservative management can be considered on a case-by-case basis.

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“…Splenic artery aneurysm (SAA) is a dilatation of more than 1cm of the splenic artery (1). It is a rare and extremely difficult diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Spontaneous splenic artery aneurysm rupture in a 38-year old female: a case report

Koutserimpas¹,

Papachristou²,

Nikitakis³

et al. 2017

GHIR

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Aneurysms of the splenic artery – A review

Cited by 161 publications

References 56 publications

Prospective randomized comparison of open versus laparoscopic management of splenic artery aneurysms: a 10-year study

Prospective randomized comparison of open versus laparoscopic management of splenic artery aneurysms: a 10-year study

Delayed presentation of a traumatic splenic artery pseudoaneurysm in an initially normal spleen: Case study and review of literature

Spontaneous splenic artery aneurysm rupture in a 38-year old female: a case report

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