Post-embolization outcomes of splenic artery pseudoaneurysms: A single-center experience

Abhinav Talwar, Gabriel Knight, Ali Al Asadi, Pouya Entezari, Richard Chen, Scott Resnick, Sri Komanduri, Ahmed Gabr, Bartley Thornburg, Riad Salem, Ahsun Riaz*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Splenic artery pseudoaneurysms (PSA) are relatively rare but associated with high mortality/morbidity when presenting acutely. Embolization has emerged as the treatment of choice. We aim to evaluate the outcomes of embolization for the treatment of splenic artery PSAs. Methods: From 2007 to 2019, all patients that underwent embolization for splenic artery PSAs were included in this IRB-approved review. Evaluated outcomes included complications, morbidity/mortality rates, and 30-day white blood cell count. Student t-tests were performed to compare laboratory values before and after embolization. 5-year survival rates were estimated using Kaplan Meier methodology. Results: A retrospective analysis of 24 patients (14 males, mean age 51 ± 19 years) who underwent splenic artery PSA embolization was performed. Fifteen PSA embolizations were performed in an emergent setting. There was technical success in 23/24 patients. Etiologies included trauma (10), pancreatitis (9), post-surgical (3), and malignancy (2). Post-embolization patients had a mean length of stay of 19 days and within 30 days, 9 patients developed leukocytosis (median of 14,800/μl). The 5-year survival rate of these patients was 89% [95% CI 75% - 100%]. Post-procedure, 4 patients developed grade 2 complications. Grade 3 complications were observed in 5 patients. One (4.2%) splenic abscess was identified. Of the 19 patients with follow-up imaging, 14 patients had splenic infarcts (5 infarcts were >50% of splenic volume). Conclusions: Splenic artery PSAs are encountered in the emergent setting and are most frequently secondary to trauma or pancreatitis. Embolization can be life-saving in these critically ill patients.

Original languageEnglish (US)
Pages (from-to)160-166
Number of pages7
JournalClinical Imaging
Volume80
DOIs
StatePublished - Dec 2021

Keywords

  • Embolization
  • Pseudoaneurysm
  • Spleen

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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