Splenic artery aneurysms – a systematic review of the literature
INTRODUCTION: Splenic artery aneurysms (SAA) are the most frequent (50 to 75%) abdominal visceral arterial aneurysms. In autopsy studies, the overall incidence is 0.01%, increasing to 10.4% with age. Due to their rarity, there is a lack of data, so we aimed to perform a systematic review of availab...
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Sociedade Portuguesa de Angiologia e Cirurgia Vascular
2025-01-01
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| Series: | Angiologia e Cirurgia Vascular |
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| Online Access: | https://acvjournal.com/index.php/acv/article/view/609 |
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| author | Marta Machado Andreia Coelho João Peixoto Luís Fernandes Roberto Boal Francisco Basílio Patrícia Carvalho Beatriz Guimarães Pedro Brandão Alexandra Canedo |
| author_facet | Marta Machado Andreia Coelho João Peixoto Luís Fernandes Roberto Boal Francisco Basílio Patrícia Carvalho Beatriz Guimarães Pedro Brandão Alexandra Canedo |
| author_sort | Marta Machado |
| collection | DOAJ |
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INTRODUCTION: Splenic artery aneurysms (SAA) are the most frequent (50 to 75%) abdominal visceral arterial aneurysms. In autopsy studies, the overall incidence is 0.01%, increasing to 10.4% with age. Due to their rarity, there is a lack of data, so we aimed to perform a systematic review of available SAA data.
METHODS: A systematic review was performed according to the PRISMA guidelines. A literature search was performed using the Medline database from January 2019 to January 2024. Only full-text articles were considered, including patients with true SAA treated by endovascular (ET) and/or open surgical (OS) means. Only articles published in English or Portuguese were considered. The investigated outcomes were postoperative complications, reinterventions, and mortality..
RESULTS: Of the 289 articles identified during the initial literature search, 87 were included in qualitative synthesis. One thousand sixty-one patients were identified with 1085 reported SAAs. The mean age was 51.62 years +/- 14.57, with older patients in the OS group (OS 54.49 years +/-15.95 vs. ET 51.92 years +/-12.83) and 39.8% (range 29.5-50.0) were male (OS 34.5% [16.2-52.8] / ET 41.7% [27.0-56.3]). A total of 12.6% (0.3-24.9%) were detected during pregnancy, with a higher frequency of pregnancy also in the OS group (OS 29.5% [0.0-9.3])/ ET 7.2% [0-14.6%]).
The mean diameter was 3.18cm +/- 2.07 (OS 4.95cm +/- 3.74 vs. ET 3.10cm +/- 1.92). The frequency of rupture was 2.8% (0.0-8.9%) and much higher in the OS group (OS 37.5% [0-100%] vs. ET 6.5% [0.0-23.4]). The types of intervention reported were ET (744 patients) and OS (317 patients: 281 conventional open reconstruction, 25 laparoscopic, and 11 robotic).
Postoperative complication rates were 12.4% (2.1-22.6) in the ET group and 9.1% (5.6-12.6) in the OS. The reintervention rate at 30 days was 5.2% (1.6-10.4) in the ET group. Reintervention after OS was 4.7% (2.2-7.2). Overall, there were three perioperative deaths, all in the OS group (mortality: 23.0 [95% CI 0.0-96.3].
CONCLUSION: SAAs rupture is associated with high mortality, so timely diagnosis and management are essential to attain a satisfactory outcome. A detailed and individualized analysis of each case and a sufficient understanding of the anatomy and hemodynamics of a particular aneurysm should guide the therapeutic decision. OS has good results in treating SAA with lower morbidity and reintervention than ET. However, ET should be a viable alternative in high-risk patients with favorable anatomy.
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| format | Article |
| id | doaj-art-9b032d595fcb4225a3441c2847576ce3 |
| institution | Kabale University |
| issn | 1646-706X 2183-0096 |
| language | Portuguese |
| publishDate | 2025-01-01 |
| publisher | Sociedade Portuguesa de Angiologia e Cirurgia Vascular |
| record_format | Article |
| series | Angiologia e Cirurgia Vascular |
| spelling | doaj-art-9b032d595fcb4225a3441c2847576ce32025-01-29T23:21:00ZporSociedade Portuguesa de Angiologia e Cirurgia VascularAngiologia e Cirurgia Vascular1646-706X2183-00962025-01-0120310.48750/acv.609Splenic artery aneurysms – a systematic review of the literatureMarta Machado0Andreia Coelho1João Peixoto2Luís Fernandes3Roberto Boal4Francisco Basílio5Patrícia Carvalho6Beatriz Guimarães7Pedro Brandão8Alexandra Canedo9Serviço Angiologia e Cirurgia Vascular – Unidade Local de Saúde Vila Nova de Gaia Espinho, Gaia, Portugal; Faculdade de Medicina da Universidade do Porto, PortugalServiço Angiologia e Cirurgia Vascular – Unidade Local de Saúde Vila Nova de Gaia Espinho, Gaia, Portugal; Faculdade de Medicina da Universidade do Porto, PortugalServiço Angiologia e Cirurgia Vascular – Unidade Local de Saúde Vila Nova de Gaia Espinho, Gaia, Portugal; Faculdade de Medicina da Universidade do Porto, PortugalServiço Angiologia e Cirurgia Vascular – Unidade Local de Saúde Vila Nova de Gaia Espinho, Gaia, Portugal; Faculdade de Medicina da Universidade do Porto, PortugalServiço Angiologia e Cirurgia Vascular – Unidade Local de Saúde Vila Nova de Gaia Espinho, Gaia, PortugalServiço Angiologia e Cirurgia Vascular – Unidade Local de Saúde Vila Nova de Gaia Espinho, Gaia, PortugalServiço Angiologia e Cirurgia Vascular – Unidade Local de Saúde Vila Nova de Gaia Espinho, Gaia, PortugalServiço Angiologia e Cirurgia Vascular – Unidade Local de Saúde Vila Nova de Gaia Espinho, Gaia, PortugalServiço Angiologia e Cirurgia Vascular – Unidade Local de Saúde Vila Nova de Gaia Espinho, Gaia, PortugalServiço Angiologia e Cirurgia Vascular – Unidade Local de Saúde Vila Nova de Gaia Espinho, Gaia, Portugal; Faculdade de Medicina da Universidade do Porto, Portugal INTRODUCTION: Splenic artery aneurysms (SAA) are the most frequent (50 to 75%) abdominal visceral arterial aneurysms. In autopsy studies, the overall incidence is 0.01%, increasing to 10.4% with age. Due to their rarity, there is a lack of data, so we aimed to perform a systematic review of available SAA data. METHODS: A systematic review was performed according to the PRISMA guidelines. A literature search was performed using the Medline database from January 2019 to January 2024. Only full-text articles were considered, including patients with true SAA treated by endovascular (ET) and/or open surgical (OS) means. Only articles published in English or Portuguese were considered. The investigated outcomes were postoperative complications, reinterventions, and mortality.. RESULTS: Of the 289 articles identified during the initial literature search, 87 were included in qualitative synthesis. One thousand sixty-one patients were identified with 1085 reported SAAs. The mean age was 51.62 years +/- 14.57, with older patients in the OS group (OS 54.49 years +/-15.95 vs. ET 51.92 years +/-12.83) and 39.8% (range 29.5-50.0) were male (OS 34.5% [16.2-52.8] / ET 41.7% [27.0-56.3]). A total of 12.6% (0.3-24.9%) were detected during pregnancy, with a higher frequency of pregnancy also in the OS group (OS 29.5% [0.0-9.3])/ ET 7.2% [0-14.6%]). The mean diameter was 3.18cm +/- 2.07 (OS 4.95cm +/- 3.74 vs. ET 3.10cm +/- 1.92). The frequency of rupture was 2.8% (0.0-8.9%) and much higher in the OS group (OS 37.5% [0-100%] vs. ET 6.5% [0.0-23.4]). The types of intervention reported were ET (744 patients) and OS (317 patients: 281 conventional open reconstruction, 25 laparoscopic, and 11 robotic). Postoperative complication rates were 12.4% (2.1-22.6) in the ET group and 9.1% (5.6-12.6) in the OS. The reintervention rate at 30 days was 5.2% (1.6-10.4) in the ET group. Reintervention after OS was 4.7% (2.2-7.2). Overall, there were three perioperative deaths, all in the OS group (mortality: 23.0 [95% CI 0.0-96.3]. CONCLUSION: SAAs rupture is associated with high mortality, so timely diagnosis and management are essential to attain a satisfactory outcome. A detailed and individualized analysis of each case and a sufficient understanding of the anatomy and hemodynamics of a particular aneurysm should guide the therapeutic decision. OS has good results in treating SAA with lower morbidity and reintervention than ET. However, ET should be a viable alternative in high-risk patients with favorable anatomy. https://acvjournal.com/index.php/acv/article/view/609Splenic artery aneurysmendovascular repairopen surgical repairoutcomessystematic review |
| spellingShingle | Marta Machado Andreia Coelho João Peixoto Luís Fernandes Roberto Boal Francisco Basílio Patrícia Carvalho Beatriz Guimarães Pedro Brandão Alexandra Canedo Splenic artery aneurysms – a systematic review of the literature Angiologia e Cirurgia Vascular Splenic artery aneurysm endovascular repair open surgical repair outcomes systematic review |
| title | Splenic artery aneurysms – a systematic review of the literature |
| title_full | Splenic artery aneurysms – a systematic review of the literature |
| title_fullStr | Splenic artery aneurysms – a systematic review of the literature |
| title_full_unstemmed | Splenic artery aneurysms – a systematic review of the literature |
| title_short | Splenic artery aneurysms – a systematic review of the literature |
| title_sort | splenic artery aneurysms a systematic review of the literature |
| topic | Splenic artery aneurysm endovascular repair open surgical repair outcomes systematic review |
| url | https://acvjournal.com/index.php/acv/article/view/609 |
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