PMC4371708_01
(A) Pre-embolization DSA presenting a giant SAA. (B) Post-embolization DSA demonstrating no contrast flow in the aneurismal sac. Note the glue material and embolization coils in the lumen of the sac and a round artifact (on the level of the coeliac trunk) arising from the intestinal gas.
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Arteriography demonstrated a dilated splenic artery with a giant non-clotted high-flow true aneurysm of 13 cm in diameter located in the middle portion of the artery. (Figure 1A) We began the interventional procedure with an attempt to close the lumen of the aneurysm with four Inconel coils (two coils of 350x10x15 mm, one coil of 350x10x12 mm, one coil of 350x15x20 mm in size) (MReye , Cook Medical, Bloomington, IN, USA) and using an 8-mm balloon catheter (Cordis Europa N.V.) introduced into the preaneurysmal portion of the splenic artery, which was ineffective because of high flow in the artery and a wide-necked aneurysmal sac. UK) inserted parallelly into the preaneurysmal portion of the splenic artery. Follow-up arteriography demonstrated complete closure of the preaneurysmal portion of the splenic artery. (Figure 1B) Abdominal CT-angiography (CTA) performed 72 hours after the procedure showed clot and embolization material in the aneurysmal sac; no residual opacification was visualized. Upper and lower poles of the spleen demonstrated slight contrast enhancement (most probably via small collateral arterial supply).
VR reconstruction CT angiography after embolization with a mixture of NBCA glue and Lipiodol. Occlusion of the distal portion of the splenic artery. The giant aneurysm does not fill with contrast medium. Glue deposits in the splenic artery.
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