Prevalence, growth rate and complications of splenic artery aneurysms in chronic liver disease patients

Abstract

Summary: Background: Chronic liver disease (CLD) patients are at greater risk for developing splenic artery aneurysm (SAA). Treatment for aneurysms > 2.5 cm in this population is considered. However, the procedure might be challenging in CLD patients, and complications may interfere in liver transplantation. We, therefore, sought to estimate the prevalence, growth rate and complications of SAA in patients with CLD. As secondary objective, we sought to evaluate whether those features differ in pre and post transplantation follow-up and among aneurysms with diameters greater or less than 2.5 cm at diagnosis. Patients and methods: We searched for the terms “SAA” and “CLD” on CT or MRI reports from January 2009 to December 2016. Patients with single examination or less than 6 months follow-up were excluded. Results: Fifty nine out of 2050 CLD patients presented SAA (prevalence of 2.9%). Fifteen patients were excluded (due to exclusion criteria). Forty-four CLD patients (mean age 55.9 years) presented 76 SAA (follow-up median of 27.2 months). Aneurysms presented mean size of 1.5 ± 0.74 cm at diagnosis and growth rate of 0.12 ± 0.14 cm/y. Two (4.5%) patients presented mild complications (aneurysm thrombosis). No significant differences were observed in the growth rates of aneurysms < 2.5 cm and ≥ 2.5 cm or in the initial size and growth rates of aneurysms of patients submitted to and not submitted to liver transplantation. Conclusions: The estimated prevalence of SAA in patients with DLC in the Brazilian population is 2.9% (CI95% 2.2–3.6%). Although SAA in CLD patients are less likely to remain stable and grow faster than in general population, aneurysms are usually diagnosed at smaller size and complications are rare. These findings might support conservative management with close surveillance, especially in smaller aneurysms.