Published online Jan 14, 2014. doi: 10.3748/wjg.v20.i2.555
Revised: November 10, 2013
Accepted: November 28, 2013
Published online: January 14, 2014
Processing time: 100 Days and 16.4 Hours
AIM: To evaluate total embolization of the main splenic artery in patients with splenic artery aneurysms (SAAs) and normal spleen.
METHODS: Thirty-five consecutive patients with SAAs were referred for treatment with coil embolization. Patients were classified into two groups: coil embolization of the main splenic artery with complete occlusion of the artery and aneurysms (group A, n = 16), and coil embolization of the aneurysmal sac with patency of the splenic artery (group B, n = 19). Data on white blood cell (WBC) and platelet counts, liver function, and complications were collected on days 7 and 30, and subsequently at a 6-mo interval postoperatively. Abdominal computed tomography was routinely performed to calculate the splenic volume before and 1 mo after the procedure, and subsequently every 6 mo during follow-up.
RESULTS: Coil embolization of the SAAs was technically successful in all 35 patients, with no procedure-related complications. The post-embolization syndrome, including abdominal pain, fever and vomiting, occurred in six patients (37.5%) in group A and three patients in group B (15.8%). There were no significant differences in WBC and platelet counts between preoperatively and at each follow-up point after the procedures. There were also no significant differences in average WBC and platelet counts between the two groups at each follow-up point. There were significant differences in splenic volume in group A between preoperatively and at each follow-up point, and there were also significant differences in splenic volume between the two groups at each follow-up point.
CONCLUSION: Total embolization of the main splenic artery was a safe and feasible procedure for patients with SAAs and normal spleen.
Core tip: Total embolization of the splenic artery sometime must be performed to achieve complete occlusion of large or multiple aneurysms. Thirty-five patients were classified into two groups: coil embolization of the splenic artery with complete occlusion of the artery and aneurysms, and coil embolization of the aneurysmal sac with patency of the splenic artery. Except for shrinkage of splenic volume, no changes in white blood cell and platelet counts or liver function were found in the former group. These results suggest that total embolization of the splenic artery is a safe and feasible procedure for patients with splenic artery aneurysm and normal spleen.