Covered Stent Assisted Coil Embolisation of a Rare Splenomesenteric Artery Aneurysm – A Case Report and Literature Review

Background Splenomesenteric artery aneurysms are a rare clinical entity occurring in <1% of the population, where the splenic artery originates from the superior mesenteric artery (SMA). These aneurysms carry a high risk of rupture due to exposure to high-flow hemodynamic stress near the SMA origin. Case Presentation A 76-year-old female was incidentally diagnosed with a 1.6 cm saccular splenomesenteric aneurysm during investigation for sepsis. The patient underwent successful endovascular exclusion using a combination of a microvascular plug and coil embolisation to address the aneurysm ‘front’ and ‘back’ doors, while a covered stent was deployed in the SMA to prevent coil prolapse and preserve mesenteric perfusion. Follow-up at 3 months confirmed successful exclusion with preserved visceral flow. Discussion Due to the rarity of this anatomical variant, documented in less than 60 cases in English literature, no standardised treatment algorithm exists. This study adds to the literature by demonstrating procedural innovation, refining management strategies and advocating for early intervention for such conditions.