Comparison of the Safety and Efficacy of Three Techniques for Coil Embolization of Splenic Artery Aneurysms: A Retrospective Single-Center Study

Abstract

Objective

The coil embolization is the most common endovascular intervention used to treat splenic artery aneurysms (SAAs) and this study aimed to analyze the safety and efficacy of 3 different coil embolization techniques.

Methods

A retrospective study was conducted on 60 patients with SAAs who underwent endovascular intervention at Ningbo NO. 2 Hospital from November 2020 to November 2023. The coil embolization technique included Sac embolization (SE, n = 25), the isolation technique (IT, n = 23) and Stent-assisted coil embolization (SACE, n = 12). Perioperative and follow-up data were collected. The primary outcomes assessed were technical success and 30 day, 12 months, and 24 months survival rates. Secondary outcomes included major complications, early or later re-intervention, Post-embolization syndrome (PES) and freedom from end-organ ischemia.

Results

The SAAs diameter in the SE group, the IT group and the SACE group were 21 mm (16-35), 21 mm (15-70) and 22.4 ± 2.4 mm, respectively. The technical success rate in the SE and SACE groups was 100%, while in the IT group was 95.7% (22/23). There were no significant differences between the 3 groups in terms of major complication (2/25 SE group, 2/23 IT group, 2/12 SACE group, P = 0.733), PES (4/25 SE group, 8/23 IT group, 1/12 SACE group, P = 0.178), or early re-intervention rates (1/25 SE group, 0/23 IT group, 1/12 SACE group, P = 0.675). The mean follow-up times for the 3 groups were 27.7 ± 10.5 months (SE group), 29.7 ± 9.1 months (IT group) and 22.8 ± 6.4 months (SACE group), respectively. Compared to the SE group, the risk of splenic infarction was higher in the IT group (0% vs 17.4%, P = 0.046). No splenic abscesses, Splenectomy, and late re-intervention occured in the cohort. The 30-day, 12-month, and 24-month mortality rates were 0. During the follow-up, 1 non-aneurysm-related death occured in the IT group (4.3%, 1/23) at 37 months postoperatively.

Conclusion

All 3 coil embolization techniques, including the SE, the IT and the SACE, have a favorable safety and efficacy. The IT may have a higher risk of splenic infarction. For SAAs with different anatomical features, the preferred coil embolization technique may be different.