The natural history of splenic artery aneurysms: factors that predict aneurysmal growth

Thomas J An; Xiaomin Chen; Omar Moustafa Fathy Omar; Patrick D Sutphin; Zubin Irani; Eric Wehrenberg-Klee; Shams Iqbal; Sanjeeva P Kalva

doi:10.1016/j.jvir.2024.04.007

The natural history of splenic artery aneurysms: factors that predict aneurysmal growth

J Vasc Interv Radiol. 2024 Apr 23:S1051-0443(24)00288-4. doi: 10.1016/j.jvir.2024.04.007. Online ahead of print.

Authors

Thomas J An¹, Xiaomin Chen², Omar Moustafa Fathy Omar³, Patrick D Sutphin¹, Zubin Irani¹, Eric Wehrenberg-Klee¹, Shams Iqbal¹, Sanjeeva P Kalva⁴

Affiliations

¹ Department of Radiology, Division of Interventional Radiology, Massachusetts General Hospital, Boston, MA, USA.
² Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
³ University of Connecticut Medical School, Farmington, CT, USA.
⁴ Department of Radiology, Division of Interventional Radiology, Massachusetts General Hospital, 55 Fruit Street, GRB 298, Boston, MA, USA 02114. Electronic address: skalva@partners.org.

PMID: 38663514
DOI: 10.1016/j.jvir.2024.04.007

Abstract

Purpose: This study examines the natural history of splenic artery aneurysms at a single institution and assesses the effect of patient factors and aneurysm characteristics on aneurysm growth.

Materials and methods: This single-center retrospective study included patients with splenic artery aneurysms that underwent serial imaging over 30 years (1990-2020). Patient demographics and aneurysm characteristics were collected. The variables contributing to aneurysm growth were assessed using non-parametric tests for continuous variables and Chi-square for categorical variables. Multivariable linear regression was performed using aneurysm growth rate as a continuous dependent variable.

Results: A total of 132 patients were included in this study. The median maximum diameter of the splenic artery aneurysms was 15.8 mm (range 4.0 - 50.0 mm). 39% of the aneurysms demonstrated interval growth over time, while the remaining 61% were stable in size. Of aneurysms that increased in size, the median aneurysm growth rate was 0.60 mm/year (range 0.03 - 5.00 mm/year). Maximum aneurysm diameter of >2 cm and the presence of >50% mural thrombus were significant positive predictors for aneurysm growth rate (p=0.020 and p=0.022, respectively). Greater than 50% rim calcification was a significant negative predictor for aneurysm growth rate (p=.009) in multivariate analysis.

Conclusion: A larger baseline splenic artery aneurysm size, presence of mural thrombus, and lack of rim calcification are associated with increased aneurysm growth rate.