Endovascular retreatment of a splenic artery aneurysm refilled by collateral branches of the left gastric artery: a case report

INTRODUCTION: A rare case of a splenic artery aneurysm refilled by a hypertrophic branch originating from the left gastric artery retreated with an endovascular approach is reported. To the best of our knowledge, this is the first such case reported in the literature. CASE PRESENTATION: A hilum splenic artery aneurysm of a 43-year-old Caucasian woman was treated with endovascular ligature. Contrast-enhanced computed tomography performed after 1 month revealed reperfusion of the aneurysm and a new angiogram demonstrated a hypertrophic vessel from her left gastric artery supplying the sac of the aneurysm. It was catheterized by splenic hilum branches and it was embolized with coil and glue. Contrast-enhanced computed tomography performed after 3 months confirmed complete exclusion of the sac of the aneurysm. CONCLUSIONS: Our patient represents the first rare case of a splenic artery aneurysm refilled from a branch of her left gastric artery not visible at first at angiography or at contrast-enhanced computed tomography performed after 1 month; it was revealed at the second angiography and it was definitively embolized. These eventualities and possibilities of treatment, although rare, should be kept in mind for each patient with similar presentation.