Page 13 - Virtual Vascular Vol 8

Brian Liu Embolize.mp4

Small splenic artery aneurysms (<2-3cm diameter) seldom rupture. Risk factors are infection,
or hormonal changes during pregnancy.

The patient was initially resuscitated and the aneurysm embolized by transarterial injection of
NBCA (N-butyl cyanoacrylate) glue. Although the aneurysm was excluded successfully, even-
tually a laparotomy and splenectomy was performed due to continued oozing and abdominal

compartment syndrome. The video shows a selective splenic angiogram before (showing
contrast leak) and after embolization.

The patient’s blood results at the most critical hour: severe anemia, raised WBC,
acute renal failure, liver derangement and metabolic acidosis.

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