Endovascular management of incidentally discovered splenic arteriovenous fistula resulting from ruptured splenic aneurysm: Case report and review of the literature Review


Authors: Alexander, E.; Santos, E.
Review Title: Endovascular management of incidentally discovered splenic arteriovenous fistula resulting from ruptured splenic aneurysm: Case report and review of the literature
Abstract: Splenic arteriovenous fistulas (SAVFs) are rare vascular anomalies, which have a described association with splenic artery aneurysms. Treatment options include surgical fistula excision, splenectomy, or percutaneous embolization. Here we present a unique case of endovascular repair of a splenic arteriovenous fistula (SAVFs) associated with a splenic aneurysm. A patient with past medical history of early-stage invasive lobular carcinoma was referred to our interventional radiology practice to discuss an incidentally discovered splenic “vascular malformation” discovered during magnetic resonance imaging of the abdomen and pelvis. Arteriography demonstrated smooth dilatation of the splenic artery, with a fusiform aneurysm which had fistulized to the splenic vein. There were high flows and early filling of the portal venous system. The splenic artery, immediately proximal to the aneurysm sac, was catheterized using a microsystem and embolized using coils and N-butyl cyanoacrylate. Complete occlusion of the aneurysm and resolution of the fistulous connection was achieved. The patient was discharged home the following day, without complication. Associated splenic artery aneurysms and SAVFs are rare occurrences. Timely management is necessary to prevent adverse sequelae such as aneurysm rupture, further enlargement of the aneurysmal sac, or portal hypertension. Endovascular treatment, including n-Butyl Cyanoacrylate glue and coils, offers a minimally invasive treatment option, with facile recovery and low morbidity. © 2023
Keywords: adult; clinical article; middle aged; cancer surgery; case report; iodinated poppyseed oil; cancer radiotherapy; nuclear magnetic resonance imaging; cancer diagnosis; disease association; thrombocytopenia; leuprorelin; general anesthesia; incidental finding; liver hemangioma; computed tomographic angiography; spleen infarction; lumpectomy; raynaud phenomenon; axillary lymph node dissection; medical history; celiac artery; spleen disease; arteriovenous fistula; coil embolization; vein diameter; splenic vein; human; female; article; artery diameter; hepatic portal vein; breast radiotherapy; splenic artery; endovascular management; invasive lobular breast carcinoma; aneurysm rupture; enbucrilate; splenic arteriovenous fistula; splenic artery aneurysm; common hepatic artery; spleen angiography; spleen artery aneurysm
Journal Title: Radiology Case Reports
Volume: 18
Issue: 7
ISSN: 1930-0433
Publisher: Elsevier Inc.  
Date Published: 2023-07-01
Start Page: 2465
End Page: 2469
Language: English
DOI: 10.1016/j.radcr.2023.04.021
PROVIDER: scopus
PMCID: PMC10206381
PUBMED: 37235078
DOI/URL:
Notes: Source: Scopus
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