A Rare Case Of A Giant Splenic Artery Aneurysm: A Simple Approach For A Complex Pathology.

Introduction Splenic artery aneurysms (SAA) represent the most common visceral aneurysms. They are more frequent in women and their incidence increases with age, hypertension and multiparity. They are rarely symptomatic and so are mostly incidental findings. Treatment options include several open or endovascular techniques. Objectives Demonstrate the potential of a simple endovascular approach in a complex SAA. Materials and Methods Report on a case giant SAA treated successfully with an endovascular approach. Results A 58-year-old female patient was sent to the emergency department after an incidental finding of a giant SAA in an MRI due to chronic abdominal pain. A CT scan was made which confirmed a distal SAA with a diameter of 90 mm. The case was discussed with radiology and general surgery and it was decided that endovascular therapy was the best approach. The patient underwent proximal plug embolization of the splenic artery. The procedure was done without complications. In the post-operative period, there was no complication and no pain associated with the recovery. Ultrasonography before discharge revealed a near total thrombosed SAA. Conclusions Giant SAA are a rare entity that may appear as a difficult pathology to treat successfully. Their high risk of rupture makes their treatment an emergency that may require a collaboration with other medical specialties. An endovascular first approach can be a good treatment choice to minimize the rupture risk and to facilitate an open surgical repair when endovascular treatment is not satisfactory.