Growth dynamics of splenic artery aneurysms: morphology, comorbidities, and vascular anatomical factors

Abstract Background Splenic artery aneurysms (SAAs) are the most common visceral artery aneurysms, often detected incidentally due to the widespread use of cross-sectional imaging. While many remain asymptomatic, rupture carries a high mortality risk. Despite established size-based treatment guideli...

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Main Authors: Ahmet Tanyeri, Aygün Katmerlikaya, Rıdvan Akbulut, Mehmet Burak Çildağ
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Medical Imaging
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Online Access:https://doi.org/10.1186/s12880-025-01879-8
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author Ahmet Tanyeri
Aygün Katmerlikaya
Rıdvan Akbulut
Mehmet Burak Çildağ
author_facet Ahmet Tanyeri
Aygün Katmerlikaya
Rıdvan Akbulut
Mehmet Burak Çildağ
author_sort Ahmet Tanyeri
collection DOAJ
description Abstract Background Splenic artery aneurysms (SAAs) are the most common visceral artery aneurysms, often detected incidentally due to the widespread use of cross-sectional imaging. While many remain asymptomatic, rupture carries a high mortality risk. Despite established size-based treatment guidelines, the impact of morphological features, vascular anatomical factors, and comorbidities on SAA growth remains unclear. This study investigates the long-term growth dynamics of SAAs and their associated risk factors. Methods This retrospective cohort study included 49 patients with true SAAs who were assessed between 2014 and 2024. The annual change in aneurysm size was calculated by measuring the difference in diameter between the initial and final computed tomography scans. Aneurysm growth was analysed in relation to morphological characteristics (mural thrombus, wall calcification), vascular anatomical factors (coeliac artery stenosis, splenic artery, superior mesenteric artery, and aortic diameters), and comorbidities (smoking, hypertension, atherosclerosis, etc.). Data were analysed using the Mann-Whitney U test, Kruskal-Wallis test, and chi-square test. A multivariable regression analysis was performed to assess the impact of comorbidities on aneurysm growth, while receiver operating characteristic (ROC) analysis was conducted to determine the predictive threshold value. A p < 0.05 was considered statistically significant. Results The mean age of the study cohort was 71 ± 16 years, with 43% of the patients being male. Aneurysm growth was observed in 45% of patients, while stability and regression were noted in 18% and 37%, respectively. The median initial maximum aneurysm diameter was 16.4 mm (8.4–36). The median growth rate was 0.55 mm/year, whereas the median regression rate was 0.86 mm/year. Aneurysm growth was significantly associated with smoking (p = 0.0001), mural thrombus presence (p = 0.021), absence of wall calcification (p = 0.041), younger age (p = 0.013), and a larger abdominal aortic diameter (p = 0.023). ROC analysis identified an initial aneurysm diameter of ≥ 17 mm as a predictive threshold for growth. Conclusion The growth dynamics of splenic artery aneurysms are heterogeneous, with smoking, mural thrombus presence, younger age, and a larger abdominal aortic diameter identified as key factors associated with aneurysm growth. Guidelines should be refined and strengthened with patient-specific follow-up and treatment algorithms based on updated clinical data. Clinical trial number Not applicable.
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spelling doaj-art-ec63993c5b9c48d39cf7c1be26bd30282025-08-24T11:57:43ZengBMCBMC Medical Imaging1471-23422025-08-0125111010.1186/s12880-025-01879-8Growth dynamics of splenic artery aneurysms: morphology, comorbidities, and vascular anatomical factorsAhmet Tanyeri0Aygün Katmerlikaya1Rıdvan Akbulut2Mehmet Burak Çildağ3Department of Radiology, Faculty of Medicine, Aydın Adnan Menderes UniversityDepartment of Radiology, Faculty of Medicine, Aydın Adnan Menderes UniversityDepartment of Radiology, Faculty of Medicine, Aydın Adnan Menderes UniversityDepartment of Radiology, Faculty of Medicine, Aydın Adnan Menderes UniversityAbstract Background Splenic artery aneurysms (SAAs) are the most common visceral artery aneurysms, often detected incidentally due to the widespread use of cross-sectional imaging. While many remain asymptomatic, rupture carries a high mortality risk. Despite established size-based treatment guidelines, the impact of morphological features, vascular anatomical factors, and comorbidities on SAA growth remains unclear. This study investigates the long-term growth dynamics of SAAs and their associated risk factors. Methods This retrospective cohort study included 49 patients with true SAAs who were assessed between 2014 and 2024. The annual change in aneurysm size was calculated by measuring the difference in diameter between the initial and final computed tomography scans. Aneurysm growth was analysed in relation to morphological characteristics (mural thrombus, wall calcification), vascular anatomical factors (coeliac artery stenosis, splenic artery, superior mesenteric artery, and aortic diameters), and comorbidities (smoking, hypertension, atherosclerosis, etc.). Data were analysed using the Mann-Whitney U test, Kruskal-Wallis test, and chi-square test. A multivariable regression analysis was performed to assess the impact of comorbidities on aneurysm growth, while receiver operating characteristic (ROC) analysis was conducted to determine the predictive threshold value. A p < 0.05 was considered statistically significant. Results The mean age of the study cohort was 71 ± 16 years, with 43% of the patients being male. Aneurysm growth was observed in 45% of patients, while stability and regression were noted in 18% and 37%, respectively. The median initial maximum aneurysm diameter was 16.4 mm (8.4–36). The median growth rate was 0.55 mm/year, whereas the median regression rate was 0.86 mm/year. Aneurysm growth was significantly associated with smoking (p = 0.0001), mural thrombus presence (p = 0.021), absence of wall calcification (p = 0.041), younger age (p = 0.013), and a larger abdominal aortic diameter (p = 0.023). ROC analysis identified an initial aneurysm diameter of ≥ 17 mm as a predictive threshold for growth. Conclusion The growth dynamics of splenic artery aneurysms are heterogeneous, with smoking, mural thrombus presence, younger age, and a larger abdominal aortic diameter identified as key factors associated with aneurysm growth. Guidelines should be refined and strengthened with patient-specific follow-up and treatment algorithms based on updated clinical data. Clinical trial number Not applicable.https://doi.org/10.1186/s12880-025-01879-8AneurysmSplenic arteryTomographyComorbidity
spellingShingle Ahmet Tanyeri
Aygün Katmerlikaya
Rıdvan Akbulut
Mehmet Burak Çildağ
Growth dynamics of splenic artery aneurysms: morphology, comorbidities, and vascular anatomical factors
BMC Medical Imaging
Aneurysm
Splenic artery
Tomography
Comorbidity
title Growth dynamics of splenic artery aneurysms: morphology, comorbidities, and vascular anatomical factors
title_full Growth dynamics of splenic artery aneurysms: morphology, comorbidities, and vascular anatomical factors
title_fullStr Growth dynamics of splenic artery aneurysms: morphology, comorbidities, and vascular anatomical factors
title_full_unstemmed Growth dynamics of splenic artery aneurysms: morphology, comorbidities, and vascular anatomical factors
title_short Growth dynamics of splenic artery aneurysms: morphology, comorbidities, and vascular anatomical factors
title_sort growth dynamics of splenic artery aneurysms morphology comorbidities and vascular anatomical factors
topic Aneurysm
Splenic artery
Tomography
Comorbidity
url https://doi.org/10.1186/s12880-025-01879-8
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AT rıdvanakbulut growthdynamicsofsplenicarteryaneurysmsmorphologycomorbiditiesandvascularanatomicalfactors
AT mehmetburakcildag growthdynamicsofsplenicarteryaneurysmsmorphologycomorbiditiesandvascularanatomicalfactors