Sequential Aspiration and injection of a Mixture of gelatin-based hemostatic agent and autologous blood clot followed by suture coiling for Effective Embolization of splenic artery pseudoaneurysm by interventional Radiologist (SAMEER): Description of a novel technique

Abstract

Pseudoaneurysms of the splenic artery usually arise as a complication of pancreatitis. Due to the risk of rupture, treatment of the pseudoaneurysms of splenic artery is considered as a priority in the management of pancreatitis. While endovascular embolization is an established minimally invasive and effective technique for the treatment of splenic artery pseudoaneurysms, however, in some cases endovascular embolization may not be feasible, owing to the difficulties in accessing the distal small pseudoaneurysms or due to financial constraints. In such a scenario, percutaneous image guided direct puncture and embolization of the pseudoaneurysms is a valuable option. While most of the previous publications have reported on the use of n‑butyl cyanoacrylate, coils and thrombin for percutaneous embolization of splenic artery pseudoaneurysms, however, these agents may not be easily accessible to many health facilities in emergency situations and their cost may limit their use. In this report, we describe a novel technique of percutaneous embolization of splenic artery pseudoaneurysms with Sequential Aspiration and injection of a Mixture of gelatin-based hemostatic agent and autologous blood clot followed by suture coiling for Effective Embolization of splenic artery pseudoaneurysm by interventional Radiologist (SAMEER technique). We demonstrate the safety and efficacy of this technique in a series of 2 cases.