Endovascular treatment of patients with splenic artery aneurysms and diabetes mellitus

Background. Splenic artery aneurysms (SAA) account for 60–70 % of all visceral artery aneurysms and are characte­rized by a high risk of rupture and mortality. SAA are sometimes associated with diabetes mellitus, likely due to diabetes-related vascular complications, including hypertension and atherosclerosis. Traditionally, the treatment of choice for SAA has been open surgery aimed at removing the aneurysm from the bloodstream. The rapid development of endovascular surgery opens new prospects for minimally invasive treatment of SAA. Aim of the study: to improve management of patients with SAA through analysis of own clinical experience of endovascular treatment and compare its results with current literature data. Materials and methods. The results of endovascular treatment of 12 patients with SAA (including 3 people with diabetes) in 2014–2023 were analyzed. True aneurysms were diagnosed in 6 cases, and pseudoaneurysms with an average diameter of 37 mm (11–95 mm) were detected in 6 cases. Results. The methods of selective/non-selective embolization (10 cases) and endoprosthesis (2 cases) were applied with 100 % success. In selective embolization and endoprosthesis of SAА, no significant splenic infarctions or the need for splenectomy occurred in any case, which indicates the safety of the method and the preservation of organ function. Long-term results were followed up in 8 patients within the planned time frames. The longest observation was 10 years. According to the data of control examinations, there was no aneurysm recurrence or reintervention. Dynamic observation of patients continues. The advantages of endovascular treatment for SAА are minimal invasiveness, rapid rehabilitation and low risk of complications in patients with concomitant diseases. Conclusions. Endovascular treatment of SAA demonstrates high technical and clinical effectiveness with a low level of perioperative complications even in patients with diabetes. With the correct selection of patients and high-quality technical performance, this technique allows us to obtain good results, which confirms its importance in the treatment of this pathology.