Elective Embolization of Splenic Artery Aneurysms with an Ethylene Vinyl Alcohol Copolymer Agent (Squid) and Detachable Coils |
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| Institution: | 1. Department of Radiology, San Raffaele Scientific Institute, Milan, Italy;2. Department of Vascular Surgery, San Raffaele Scientific Institute, Milan, Italy;3. Department of Radiology and Vascular Surgery, Vita-Salute San Raffaele University, Milan, Italy;1. Department of Radiology, University of Michigan, Ann Arbor, Michigan;2. Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan;3. Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan;1. Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada;2. Department of Medical Imaging, Division of Vascular and Interventional Radiology, University Health Network, 4th Floor, 263 McCaul Street, Toronto, Ontario M5T 1W7, Canada;1. Division of Vascular and Interventional Radiology, Department of Medical Imaging, Toronto General Hospital, 585 University Avenue, Toronto, Ontario, Canada M5G 2N2;2. Division of Vascular Surgery, Department of Surgery, Toronto General Hospital, 585 University Avenue, Toronto, Ontario, Canada M5G 2N2 |
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| Abstract: | PurposeTo report the safety and efficacy of the embolization of splenic artery aneurysms (SAAs) with coils plus ethylene vinyl alcohol copolymer (EVOH) agent.Materials and MethodsA single-center retrospective study was conducted from 2016 to 2019 to collect SAAs. Twelve asymptomatic patients (mean age, 59 years) with 15 SAAs (mean size, 23.6 mm; size range, 15–40 mm) were treated with embolization. Embolization was performed with EVOH (Squid 8/34) and fibered detachable coils. Transfemoral embolization was performed with a microcatheter to achieve a splenic artery occlusion embolizing the SAA and its efferent and afferent branches. Follow-up was based on color Doppler ultrasound at 24 hours and on computed tomography (CT) angiography at 1 (n = 12) and 6 months (n = 12) after embolization. Mean number of coils and Squid vials used for each patient, major/minor complications, technical success, 30-day clinical success, cases of revascularization/reintervention, and mortality were assessed. Technical success was defined as complete exclusion of the aneurysmal segment and cessation of blood flow into the sac. Clinical success at 1 month was based on the absence of clinical symptoms and the exclusion of aneurysm revascularization on CT angiography.ResultsThe mean number of coils and Squid vials was 5.75 (standard deviation SD], 1.58; range, 3–9) and 1.41 (SD, 0.49; range, 1–2), respectively. Both technical and 30-day clinical success were 100%, with no cases of aneurysm revascularization (CT angiography performed in all patients at 1 month and 6 months and in 3 patients at 24 months). No major complications or fatal events were recorded. In terms of minor complications, 2 cases of mild pancreatitis (transient amylases increase) and 1 case of focal splenic ischemia without clinical sequelae were recorded.ConclusionsEmbolization in SAAs using coils plus EVOH was safe and effective without SAA revascularization |
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