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.