Natural History and Long-term Follow-up of 890 Splenic Artery Aneurysms

Though splenic artery aneurysms (SAAs) are the most common visceral aneurysm, there is a paucity of literature on natural history SAAs. The objective this study was to review patients with SAA. This single-institution retrospective analysis studied all SAA diagnosed by computed tomography imaging between 2015 and 2019, identified our radiology database. Imaging, demographic, clinical data obtained via electronic medical record. cohort consists 853 894 SAA; 693 were female (81.2%), 37 (5.3%) them childbearing age (15-50 years). Mean at diagnosis 70.9 years (range, 28-100 Medical comorbidities included hypertension (70.2%), prior smoking (32.2%), hypercholesterolemia (54.7%) (Table I). Imaging indications abdominal pain (37.3%), unrelated follow-up (28.0%) previously noted aneurysm (8.6%). diameter 13.3 ± 6.3 mm. Eighty-one (9.0%) had more than one Anatomical locations hilum (36.0%), distal (30.3%), mid (23.9%), proximal (9.7%). Radiographically, majority saccular (72.4%). Additional characteristics calcification (88.5%) thrombus (13.9%). Associated findings aortic atherosclerosis (58.7%), (7.0%), additional (4.1%). One patient (a 38-year-old female) initially time rupture 25-mm aneurysm; underwent immediate endovascular intervention no complications. among 812 4.1 4.0 years. radiological 514 3.8 6.8 Of these, 122 (23.7%) experienced growth, mean growth 2.5mm. Aneurysm rates for initial sizes <10 mm (n = 123), 10 19 353), 20 29 34), >30 4) 0.166 mm/y, 0.172 0.383 0.246 respectively. entire cohort, 27 (3.2%) eventually (81.5% endovascular), including size/growth criteria (70.4%) symptom development (18.5%). On multivariate analysis, only tobacco use (P .028) significantly associated growth. Data stratified sex presented in Table II. SAAs remained stable size, few requiring over 4 Current guidelines recommending treatment asymptomatic appear appropriate given their slow progression. Despite societal recommendations women age, minority series, indicating that these may not be well known general community.Table IDemographicsMean (range) diagnosis, years70.9 (28-100)Female81.2%Comorbidities Active smoking3.5% Prior smoking32.2% Hypertension70.2% Hyperlipidemia54.7% Diabetes mellitus21.5% Coronary disease23.7% Connective tissue or rheumatologic disease6.1% Obesity30.2% stroke7.5% Peripheral arterial disease4.6% Immunosuppressive medications5.0% Portal hypertension5.6% Cirrhosis3.0% Liver transplant.82% Malignancy25.3% Atrial fibrillation12.3% Splenomegaly1.1% Abdominal aneurysm7.0% aneurysm4.1% Open table new tab IIWomen 37)Women nonchildbearing 656)P valueMean mm15.97 7.812.59 5.52.0004Rupture1 (2.7%)0–Intervention7 (18.9%)11 (1.7%)<.0001Aneurysm growth4 (10.8%)87 (13.3%).627