Aneurysm Resection and Vascular Reconstruction for True Aneurysm at the Initial Segment of Splenic Artery

• Published in: Journal of Huazhong University of Science and Technology. Medical sciences Vol. 35; no. 3; pp. 439 - 444
• Main Author: 王春喜 韩丽娜 梁发启 褚福涛 贾鑫
• Format: Journal Article
• Language: English
• Published: Wuhan Huazhong University of Science and Technology 01.06.2015; Department of General Surgery of PLA General Hospital, Beijing 100853, China%Department of Cardiovascular Internal Medicine, Nanlou Branch of PLA General Hospital, Beijing 100853, China
• Subjects: Aneurysm - surgery; Blood Vessel Prosthesis Implantation - methods; Female; Follow-Up Studies; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Retrospective Studies; Splenic Artery - surgery; Survival Analysis; Treatment Outcome; Veins - transplantation; 动脉瘤; 急性心肌梗死; 脾动脉; 腹主动脉; 血管造影; 计算机断层扫描; 起始段; 静脉移植; aneurysm; artery reconstruction; resection
• ISSN: 1672-0733; 1993-1352; 1993-1352
• DOI: 10.1007/s11596-015-1450-1

The aneurysms at the initial segment of splenic artery are rare. This paper aimed to investigate the methods to treat the true aneurysm at the initial segment of splenic artery by aneurysmectomy plus vascular reconstruction. Retrospectively reviewed were 11 cases of true aneurysm at the initial segment of splenic artery who were treated in our hospital from January 2000 to June 2013. All cases were diagnosed by color ultrasonography, computer tomography（CT） and angiography. Upon resection of the aneurysm, the auto-vein transplantation was performed in situ between the hepatic artery and the distal part of the splenic artery in 1 case; the artificial vessel bypass was done between the infra-renal aorta and distal portion of the splenic artery in 7 cases; the splenectomy was done in 2 cases; the splenectomy in combination with ligation of multiple small aneurysms were performed in 1 case. All cases were cured and discharged from the hospital 10–14 days after operation. A 1–14 year follow-up showed that 9 cases survived, and 2 cases died, including 1 case who died of acute myocardial infarction 2 years after aorta-splenic artery bypass operation and 1 case who died of acute cerebral hemorrhage 5 years after aneurysm resection and the splenectomy. Among 6 cases receiving aorta-splenic artery bypass, 1 gradually developed stenosis at anatomosed site, which eventually progressed to complete occlusion 2 years to 6 years after operation, without suffering from splenic infarction because the spleen was supplied by the short gastric vessel and its collaterals. The other 5 cases receiving aorta-splenic artery bypass and 1 case undergoing autologous vascular transplantation did not develop stricture or pseudoaneurysm at the stoma. Our study showed that the aneurysmectomy plus vascular reconstruction is a better treatment for aneurysm at the initial segment of splenic artery.