Splenic artery aneurysm: endovascular, laparoscopic, or open surgery?

Abstract

Introduction: Splenic artery aneurysms are a rare disease with a high degree of fatality. They are considered as the third most common aneurysm after aortic and iliac artery aneurysms. The incidence in women is four times higher than men, and they are usually diagnosed incidentally or symptomatically. Objective: To carry out a narrative review seeking to synthesize epidemiology, pathophysiology, diagnosis, and treatment options for splenic artery aneurysms. Method: For the selection of articles, the PUBMED database was used according to the search strategy: "Splenic artery aneurysm" OR "Visceral aneurysms" AND (“treatment” OR “diagnosis”). Results: The incidence is higher in women (women: men 4: 1), in the sixth decade of life, with up to 80% in patients older than 50. True splenic artery aneurysms are generally related to the condition of increased flow and occurring mainly during pregnancy (especially in multiparous women), in arteriovenous fistulas, malformation, and portal hypertension. Due to the greater accessibility to imaging exams, the diagnosis has been early, despite being mostly incidental, thus favoring, in an elective therapeutic intervention, considerably decreasing mortality from complications such as rupture. Considerations: Although splenic artery aneurysms are rare and potentially fatal, their diagnosis is usually accidental and sometimes late when symptomatic. Due to technological advances, the treatment preference is for the endovascular approach since it guarantees low mortality and less morbidity in the short term.