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Ege Journal of Medicine
2018, Cilt 57, Sayı 3, Sayfa(lar) 147-151
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Emergency endovascular treatment in splenic artery pseudoaneurym
Elçin Aydın1, Mustafa Gök2, Halil Bozkaya3, Celal Çınar3, Mustafa Parıldar3
1Başkent Üniversitesi İzmir Araştırma ve Uygulama Hastanesi, Radyoloji Kliniği, İzmir, Türkiye
2Adnan Menderes Üniversitesi Tıp Fakültesi, Radyoloji Anabilim Dalı, Aydın, Türkiye
3Ege Üniversitesi Tıp Fakültesi, Radyodiagnostik Anabilim Dalı, İzmir, Türkiye
Keywords: Acute abdomen, splenic artery pseudoaneursym, endovascular treatment

Aim: Although splenic artery pseudoaneuryms (SAPA) are rare cause of acute abdomen, when they rupture they have high mortality rates. Posttraumatic splenic artery injury and/or active bleeding have also high mortality rates and they require immediate treatment. In our study we aim to discuss the endovascular treatment option for SAPA with our experience and literature.

Materials and Methods: Between 2002-2016 there were 9 patients (6 male,3 female) who had endovascular treatment for SAPA diagnosed with abdominal CT. Endovascular treatment options were platinum coil embolization (n=8) or covered stent implantation (n=1).

Results: Mean age for 9 patients (6 male, 3 female) was 44.8 (in the range between 23-66 years). The only clinical symptom was massive gastrointestinal bleeding (9 patients). Etiologies for SAPAs were; trauma (n=5), iatrogenic (n=2) and acute pancreatitis (n=2). From CT scans and angio images there were pseudoaneurysms (PA) (n=9) and in one patient there were both PA and splenic arterio-venous fistula (AVF) between splenic artery and vein. Seven patients were treated with splenic artery embolization [parent artery occlusion (PAO)]. Other two patients with PA were treated with PA coiling and covered stent implantation. After treatment, results were good and in follow-up period (1-14 months) no complications were occured.

Conclusion: Splenic artery injury is rare cause of acute abdomen with high mortality rate, and it can be treated safely with endovascular technics with good results.


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