European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery · 2026
Long Term Growth and Rupture Risk, and Associated Factors of Splenic Artery Aneurysms in a Large Observational Cohort.
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Larkio Janne, Söderström Maria, Holmström Jenni, Peltola Erno, Vikatmaa Pirkka, Venermo Maarit, Tulamo Riikka, Aro Ellinoora
Аннотация
OBJECTIVE: The aim of this retrospective observational study was to analyse imaging and patient related parameters of splenic artery aneurysms (SAAs) and their impact on SAA growth and rupture.
METHODS: The term aneurysm was systematically searched for in the radiology reports of 1.9 million abdominal imaging studies conducted in a university hospital district between 2006 and 2020. Clinical data were collected from the medical records and causes of death from a registry. Computed tomography scans were reviewed for radiological parameters. Multivariable tests were used to analyse factors associated with SAA growth and rupture.
RESULTS: Eight hundred and twenty-one SAAs in 670 patients were identified from 35 378 radiology reports containing the term aneurysm. The mean SAA diameter ± standard deviation at presentation was 14.1 ± 5.6 mm. Follow up imaging was available for 584 SAAs (71.1%), with a mean follow up of 79.2 ± 54.0 months. Growth was observed in 77 (13.2%) of these SAAs. The mean growth rate was 0.097 ± 0.50 mm/year, and 0.73 ± 1.22 mm/year in growing SAAs. Three SAAs (0.4%) ruptured at a mean size of 32 mm. Aneurysm wall calcification was independently associated with decreased risk of SAA growth or rupture: mild calcification (odds ratio [OR] 0.28, 95% confidence interval [CI] 0.12 - 0.67; p = .004), over one third circular calcification (OR 0.16, 95% CI 0.06 - 0.43; p< .001), and full circumference, i.e., eggshell calcification (OR 0.05, 95% CI 0.02 - 0.16; p < .001). Aneurysm location at the splenic hilum was also associated with decreased growth and rupture risk (OR 0.43, 95% CI 0.22 - 0.85; p = .015), while presence of abdominal aortic aneurysm (AAA) was associated with increased risk (OR 8.08, 95% CI 1.08 - 60.30; p = .042).
CONCLUSION: Most SAAs remained stable in size, with only a few ruptures occurring over a mean follow up of 6 years. Aneurysm wall calcification and SAA location at the splenic hilum were associated with a decreased risk of growth and rupture, while the presence of AAA was associated with increased risk.
METHODS: The term aneurysm was systematically searched for in the radiology reports of 1.9 million abdominal imaging studies conducted in a university hospital district between 2006 and 2020. Clinical data were collected from the medical records and causes of death from a registry. Computed tomography scans were reviewed for radiological parameters. Multivariable tests were used to analyse factors associated with SAA growth and rupture.
RESULTS: Eight hundred and twenty-one SAAs in 670 patients were identified from 35 378 radiology reports containing the term aneurysm. The mean SAA diameter ± standard deviation at presentation was 14.1 ± 5.6 mm. Follow up imaging was available for 584 SAAs (71.1%), with a mean follow up of 79.2 ± 54.0 months. Growth was observed in 77 (13.2%) of these SAAs. The mean growth rate was 0.097 ± 0.50 mm/year, and 0.73 ± 1.22 mm/year in growing SAAs. Three SAAs (0.4%) ruptured at a mean size of 32 mm. Aneurysm wall calcification was independently associated with decreased risk of SAA growth or rupture: mild calcification (odds ratio [OR] 0.28, 95% confidence interval [CI] 0.12 - 0.67; p = .004), over one third circular calcification (OR 0.16, 95% CI 0.06 - 0.43; p< .001), and full circumference, i.e., eggshell calcification (OR 0.05, 95% CI 0.02 - 0.16; p < .001). Aneurysm location at the splenic hilum was also associated with decreased growth and rupture risk (OR 0.43, 95% CI 0.22 - 0.85; p = .015), while presence of abdominal aortic aneurysm (AAA) was associated with increased risk (OR 8.08, 95% CI 1.08 - 60.30; p = .042).
CONCLUSION: Most SAAs remained stable in size, with only a few ruptures occurring over a mean follow up of 6 years. Aneurysm wall calcification and SAA location at the splenic hilum were associated with a decreased risk of growth and rupture, while the presence of AAA was associated with increased risk.