Yoon Taein, Kwon Taewon, Kwon Hyunwook, Han Youngjin, Cho Yongpil
Division of Vascular Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Vasc Specialist Int. 2014 Dec;30(4):120-4. doi: 10.5758/vsi.2014.30.4.120. Epub 2014 Dec 31.
The purpose of this study was to report on splenic artery aneurysms (SAAs) treated by transcatheter embolization in our single-center institution and to evaluate the clinical outcomes of patients with SAA by aneurysm location.
The original medical records and imaging results of 52 patients with SAA treated in our center between January 1, 1995 and December 31, 2013 were reviewed. Of these cases, 7 patients (13.5%) underwent surgery, 4 patients (7.5%) underwent serial observation, and 1 patient had stent insertion only, leaving 40 patients (78.9%) who underwent endovascular treatment using a coil, with or without N-butyl-2-cyanoacrylate.
Aneurysms were located in the distal third of the splenic artery in 27 patients (67.5%), in the middle third in 9 cases (22.5%), and in the proximal third in 4 cases (10%). Of the 40 included patients, 25 were female (62.5%). Twenty-eight patients (70%) were asymptomatic. The mean aneurysm diameter was 2.48 cm (range, 0.8-6.0 cm). Complications involved pancreatitis (n=1) and early spleen infarction (n=29: <1/3 in 14, 1/3-2/3 in 10, and >2/3 in 5). Postembolization syndrome was noted in 26 patients (65%). There were no significant differences by aneurysm location in the postoperative increase in the values of white blood cells, amylase, lipase, and C-reactive protein (P=0.067, P=0.881, P=0.891, and P=0.188, respectively).
At our institution, endovascular management is safe, has high technical success, and represents the first-line treatment for SAA, regardless of aneurysm location.
本研究旨在报告在我们单中心机构中经导管栓塞治疗脾动脉瘤(SAA)的情况,并按动脉瘤位置评估SAA患者的临床结局。
回顾了1995年1月1日至2013年12月31日期间在我们中心接受治疗的52例SAA患者的原始病历和影像结果。在这些病例中,7例(13.5%)接受了手术,4例(7.5%)接受了连续观察,1例仅进行了支架置入,其余40例(78.9%)接受了使用弹簧圈的血管内治疗,使用或未使用N-丁基-2-氰基丙烯酸酯。
27例(67.5%)动脉瘤位于脾动脉远侧三分之一处,9例(22.5%)位于中间三分之一处,4例(10%)位于近侧三分之一处。纳入的40例患者中,25例为女性(62.5%)。28例(70%)患者无症状。动脉瘤平均直径为2.48 cm(范围0.8 - 6.0 cm)。并发症包括胰腺炎(n = 1)和早期脾梗死(n = 29:14例梗死面积<1/3,10例梗死面积为1/3 - 2/3,5例梗死面积>2/3)。26例(65%)患者出现栓塞后综合征。术后白细胞、淀粉酶、脂肪酶和C反应蛋白值升高在不同动脉瘤位置之间无显著差异(P分别为0.067、0.881、0.891和0.188)。
在我们机构,血管内治疗是安全的,技术成功率高,无论动脉瘤位置如何,均是SAA的一线治疗方法。