Endoscopic ultrasound-guided coil and glue for treatment of splenic artery pseudo-aneurysm: new kid on the block!

BACKGROUND AND STUDY AIMS: Pseudoaneurysm most commonly involves the splenic artery and is conventionally treated with angioembolization or surgery. Herein we describe six patients with splenic artery pseudoaneurysm who were treated using a new technique of endoscopic ultrasound (EUS)-guided glue and coil injection. PATIENTS AND METHODS: Six patients (median age 36.7, range: 19 – 60, M: F = 5:1) with splenic artery pseudoaneurysm who had failed angiographic embolization underwent EUS-guided transgastric injection of coil and glue injection between July 2016 and September 2017. RESULTS : The diameter of the splenic artery pseudoaneurysms varied from 2.5 cm to 6.5 cm . The size (8, 14 and 16 mm) and number (1 to 5) of coils and amount of glue (1 – 2 mL) injected all were greater in larger aneurysm. All six patients had complete occlusion of the pseudoaneurysm as determined by using computed tomography at 4 weeks and EUS at 12 weeks. No complication was encountered. CONCLUSION : EUS-guided coil and glue injection for obliteration of splenic artery pseudoaneurysm is a feasible, highly effective and safe technique.