Splenic Artery Aneurysm Occlusion by Overlapping Gore® Viabahn® Endoprosthesis Devices

A Piece of Cake or - Once in a While - a Real Challenge

Authors

DOI:

https://doi.org/10.59667/sjoranm.v10i1.12

Keywords:

Splenic artery aneurysm, Endovascular treatment, Covered stent, Stent-graft deployment, Gore Viabahn endoprosthesis, Device displacement, Bailout technique

Abstract

A 63-year-old patient with chronic thoracoabdominal aortic dissection was found to have a 2.2 cm wide-neck splenic artery aneurysm. The interdisciplinary treatment plan required exclusion of the splenic artery aneurysm before fenestrated endovascular aortic repair. During the first intervention, deployment of a Viabahn endoprosthesis was technically difficult. The device kinked and displaced distally, leaving the aneurysm perfused. Because the intervention had already lasted more than 3 hours and required approximately 150 mL of non-ionic contrast medium, the procedure was stopped. The patient was monitored first in the recovery room and then on a regular ward. A longer Viabahn device was ordered and delivered at short notice. Two days later, balloon-assisted realignment of the displaced stent graft and overlapping placement of the second device achieved complete aneurysm exclusion while preserving splenic perfusion. The patient was discharged home the following day. One-year CT angiography confirmed persistent exclusion of the aneurysm and patency of the treated splenic artery. This case illustrates practical bailout techniques for an uncommon but demanding deployment complication.

Author Biographies

  • Frank Mosler, Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, University Hospital of Bern, University of Bern

    Board-certified Radiologist & Neuroradiologist; Senior Consultant, Inselspital, Bern University Hospital

    Dr. med. Frank Mosler is a board-certified radiologist and neuroradiologist with more than 30 years of clinical and academic experience across major European university centers. He completed his medical education and early specialty training in radiology and neurosurgery at Charité University Hospital in Berlin. He later specialized in interventional neuroradiology at Alfried Krupp Hospital in Essen, where he also held senior leadership responsibilities.

    His professional career has included academic medicine, diagnostic and interventional radiology, neuroradiology, healthcare management, quality assurance, and scientific publishing in Germany and Switzerland. Since 2017, he has been affiliated with the Department of Diagnostic, Interventional and Pediatric Radiology (DIPR) at Inselspital, Bern University Hospital.

    As Editor-in-Chief of the Swiss Journal of Radiology and Nuclear Medicine, Dr. Mosler leads the journal's editorial and scientific strategy and holds overall responsibility for editorial policy, publication standards, scientific integrity, and final editorial decision-making.

    Institutional affiliation: University Institute of Diagnostic, Interventional and Pediatric Radiology, Inselspital
    Location: Bern, Switzerland
    ROR: 01q9sj412

  • Gerd Nöldge, Institut für Medizinische Radiologie (IMR) Bürgerspital Solothurn, Solothurn, Switzerland

    Founding Editor & Honorary Editor
    Switzerland & Germany
    Senior Consultant Radiology, University Hospitals Heidelberg & Bern

    Prof. Dr. med. Gerd Nöldge is a renowned German radiologist and pioneer in interventional radiology. As former Senior Consultant at Heidelberg University Hospital, he made groundbreaking contributions to gastrointestinal artery embolization, for which he received the inaugural Wilhelm Conrad Röntgen Prize in 1985. He played a key role in advancing kyphoplasty techniques for osteoporotic vertebral fractures, providing long-term evidence for the efficacy and stability of calcium phosphate cement in vertebral body augmentation.

    Prof. Nöldge has also significantly contributed to the clinical development and refinement of transjugular intrahepatic portosystemic shunt (TIPS) procedures, improving outcomes in patients with portal hypertension. His dedication to education and international collaboration has fostered enduring partnerships, including medical exchange programs with leading institutions in China.

    As Founding Editor of the Swiss Journal of Radiology and Nuclear Medicine, Prof. Nöldge played a decisive role in the establishment and early development of SJORANM. His appointment as Honorary Editor recognizes his founding contribution, his longstanding scientific commitment, and his lasting importance to the journal. 

    Former institutional affiliation: University Hospital Heidelberg – Diagnostic and Interventional Radiology
    Location: Heidelberg, Germany & Bern, Switzerland
    ROR: 013czdx64

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SJORANM article cover, Vol. 10 No. 1 (2024). Holographic symbolic illustration for article 39.

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Published

2024-07-30

Data Availability Statement

Data sharing is not applicable to this article, as no datasets were generated or analyzed during the current study.

Issue

Vol. 10 No. 1 (2024)

Section

Case reports

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Copyright (c) 2024 Nando Mertineit, Amgad El Mekabaty, Gholam Reza Afarideh, Carlos Buitrago Tellez, Pascal Kissling, Stefanie Garni, Frank Mosler, Gerd Nöldge

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How to Cite

Mertineit, N., El Mekabaty, A., Reza Afarideh, G., Buitrago Tellez, C., Kissling, P., Garni, S., Mosler, F., & Nöldge, G. (2024). Splenic Artery Aneurysm Occlusion by Overlapping Gore® Viabahn® Endoprosthesis Devices: A Piece of Cake or - Once in a While - a Real Challenge. Swiss Journal of Radiology and Nuclear Medicine, 10(1), 1-17. https://doi.org/10.59667/sjoranm.v10i1.12

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