Elective Embolization of Splenic Artery Aneurysms with an Ethylene Vinyl Alcohol Copolymer Agent (Squid) and Detachable Coils

J Vasc Interv Radiol. 2020 Jul;31(7):1110-1117. doi: 10.1016/j.jvir.2019.12.797. Epub 2020 Apr 2.

Abstract

Purpose: To report the safety and efficacy of the embolization of splenic artery aneurysms (SAAs) with coils plus ethylene vinyl alcohol copolymer (EVOH) agent.

Materials and methods: A single-center retrospective study was conducted from 2016 to 2019 to collect SAAs. Twelve asymptomatic patients (mean age, 59 years) with 15 SAAs (mean size, 23.6 mm; size range, 15-40 mm) were treated with embolization. Embolization was performed with EVOH (Squid 8/34) and fibered detachable coils. Transfemoral embolization was performed with a microcatheter to achieve a splenic artery occlusion embolizing the SAA and its efferent and afferent branches. Follow-up was based on color Doppler ultrasound at 24 hours and on computed tomography (CT) angiography at 1 (n = 12) and 6 months (n = 12) after embolization. Mean number of coils and Squid vials used for each patient, major/minor complications, technical success, 30-day clinical success, cases of revascularization/reintervention, and mortality were assessed. Technical success was defined as complete exclusion of the aneurysmal segment and cessation of blood flow into the sac. Clinical success at 1 month was based on the absence of clinical symptoms and the exclusion of aneurysm revascularization on CT angiography.

Results: The mean number of coils and Squid vials was 5.75 (standard deviation [SD], 1.58; range, 3-9) and 1.41 (SD, 0.49; range, 1-2), respectively. Both technical and 30-day clinical success were 100%, with no cases of aneurysm revascularization (CT angiography performed in all patients at 1 month and 6 months and in 3 patients at 24 months). No major complications or fatal events were recorded. In terms of minor complications, 2 cases of mild pancreatitis (transient amylases increase) and 1 case of focal splenic ischemia without clinical sequelae were recorded.

Conclusions: Embolization in SAAs using coils plus EVOH was safe and effective without SAA revascularization.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aneurysm / diagnostic imaging
  • Aneurysm / therapy*
  • Embolization, Therapeutic / adverse effects
  • Female
  • Humans
  • Male
  • Middle Aged
  • Polyvinyls / administration & dosage*
  • Polyvinyls / adverse effects
  • Retrospective Studies
  • Splenic Artery* / diagnostic imaging
  • Time Factors
  • Treatment Outcome

Substances

  • Polyvinyls
  • ethylene-vinyl alcohol copolymer