Endovascular Embolization of a Large High-Flow Splenic Arteriovenous Fistula and Aneurysm Using the Amplatzer Vascular Plug II

Ann Vasc Surg. 2016 Feb:31:210.e1-3. doi: 10.1016/j.avsg.2015.09.012. Epub 2015 Nov 26.

Abstract

We describe the use of an Amplatzer Vascular Plug (AVP) II for embolizing a large high-flow splenic arteriovenous fistula and an aneurysm in a young patient. This patient presented to our center with persistent mild abdominal discomfort, 5 years after open splenectomy. Contrast-enhanced computed tomography angiography showed the presence of a fistula between the splenic arterial and splenic venous remnants and a resultant fusiform aneurysmal dilatation of the residual splenic vein. We decide to embolize the splenic artery with a 12-mm diameter AVP II with an oversizing by 70% of the vessel diameter. Celiac angiography performed 5 min postembolization revealed complete obliteration of the splenic artery and closure of the arteriovenous fistula. The overall procedure time was 40 min, and overall radiation exposure was 32 Gy cm(2) (dose-area product).

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aneurysm / diagnosis
  • Aneurysm / etiology
  • Aneurysm / physiopathology
  • Aneurysm / therapy*
  • Angiography, Digital Subtraction
  • Arteriovenous Fistula / diagnosis
  • Arteriovenous Fistula / etiology
  • Arteriovenous Fistula / physiopathology
  • Arteriovenous Fistula / therapy*
  • Blood Flow Velocity
  • Embolization, Therapeutic / instrumentation*
  • Female
  • Humans
  • Radiation Dosage
  • Radiation Exposure
  • Regional Blood Flow
  • Splenectomy / adverse effects*
  • Splenic Artery / diagnostic imaging
  • Splenic Artery / physiopathology*
  • Splenic Vein / diagnostic imaging
  • Splenic Vein / physiopathology*
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome