Recommendations
6
Splenic Artery Aneurysm (SAA)
Recommendation
Grade/
LOE
3.4 In treatment of SAA, we suggest that the splenic artery does not
routinely require preservation or revascularization.
2-C
3.5 In treatment of distal SAA adjacent to the hilum of the spleen, we
suggest open surgical techniques including possible splenectomy as
opposed to endovascular methods, given concern for the possibility of
end-organ ischemia, including splenic infarction and pancreatitis.
2-C
3.6 In pregnant women with SAA, treatment decisions should be
individualized regardless of size, and the potential morbidity to both
the mother and fetus should be considered.
BPS
4. Screening
4.1 We suggest screening of patients with SAAs for other intra-abdominal,
intrathoracic, intracranial, and peripheral artery aneurysms.
2-B
5. Surveillance and follow-up
5.1 In patients in whom an SAA is being observed with a nonoperative or
noninterventional approach, we suggest annual surveillance with CT or
ultrasound to assess for growth in size.
2-B
5.2 Aer endovascular intervention for SAAs, we suggest periodic
surveillance with CTA, ultrasound, or MRA to assess for the possibility
of endoleak or aneurysm reperfusion that could lead to a continued risk
of aneurysm growth or rupture.
2-B
(cont'd)
