To evaluate the safety and early- to mid-term efficacy of different modalities for treating splenic artery aneurysm (SAA) mainly by endovascular spring coil embolization technique.

This study was a retrospective cohort study. The clinical data of 46 patients with SAA admitted to Department of Vascular Surgery, Kunshan Hospital Affiliated to Jiangsu University School of Medicine from December 2018 to August 2022 were retrospectively analyzed, of which 29 cases were treated with interventional therapy, mainly using endovascular spring coil embolization, 2 cases with emergency open surgery, and 15 cases with regular follow-up. The perioperative complications of the patients and the results of the follow-ups were observed, and the safety and clinical efficacy of the three treatment modalities were evaluated.

Surgical treatment was successful in 31 patients. Among them, 29 cases underwent spring-coil embolization, with a operation time of (48.3±12.6)min, hospitalization time of (2.3±0.8)d, and treatment cost of (63±11) thousand yuan. Postoperatively, 3 patients developed vague pain in the left quarter rib, and 1 patient showed low fever. Two cases with SAA rupture underwent SAA+splenectomy in the emergency, with a median operation time of 67.0(54.5,79.5)min, hospitalization time of 7.5(7.3,7.8) days, and treatment cost of 35(34,35) thousand yuan. No postoperative serious complications such as hemorrhage, infection, pancreatic fistula, and pancreatitis. At the follow-up of (13.5±8.0) months, 2 patients with endovascular treatment developed small splenic infarction, and the rest of the patients had no severe complications such as heterotopic embolism, large splenic infarction and infection, and 15 patients with conservative treatment had no noticeable enlargement of the tumor in the review.

Patients with SAA should be examined individually according to the anatomical location, size, and progression of the lesion, and those with surgical indications should be treated with spring coil embolization, which is safe and effective, with less trauma, fewer complications, and shorter hospital stay, but with relatively high cost. Surgical treatment of emergent ruptured SAA is relatively reliable, while dynamic follow-up may be considered for those without indication for surgical intervention.

Splenic artery aneurysm; Spring coil; Embolization; Endovascular therapy