From the Research
Regular follow-up for a 14mm calcified splenic artery aneurysm is recommended, typically with annual imaging such as ultrasound or CT scan. This incidental finding does not require immediate intervention as splenic artery aneurysms smaller than 2cm generally have a low risk of rupture, especially when calcified, which indicates chronicity and some degree of stability 1. However, monitoring is important because growth over time could increase rupture risk.
Key Considerations
- If the aneurysm grows to exceed 2cm, shows signs of expansion between imaging studies, causes symptoms like abdominal pain, or occurs in women of childbearing age (who have higher rupture risk during pregnancy), intervention may be warranted 1.
- Treatment options would include endovascular coiling, stenting, or surgical management.
- During follow-up visits, patients should report any new abdominal pain promptly.
- The overall rupture risk for small, calcified splenic artery aneurysms is approximately 2-3%, but regular monitoring provides reassurance and allows for timely intervention if needed.
Diagnostic Approaches
- Multidetector-row CT angiography (MDCTA) allows detailed visualization of the vascular anatomy and may allow identification of aneurysms and pseudoaneurysms that affect the splenic artery 2.
- CT appearances can vary, and radiologists should recognize the clinical and pathophysiologic distinctions between true aneurysms and pseudoaneurysms 3.