PMID- 25282697
OWN - NLM
STAT- MEDLINE
DCOM- 20150206
LR  - 20161125
IS  - 1097-6809 (Electronic)
IS  - 0741-5214 (Linking)
VI  - 60
IP  - 6
DP  - 2014 Dec
TI  - Ruptured splenic artery aneurysms are exceedingly rare in pregnant women.
PG  - 1520-3
LID - S0741-5214(14)01674-7 [pii]
LID - 10.1016/j.jvs.2014.08.108 [doi]
AB  - OBJECTIVE: Pregnancy is cited as the most important risk factor for splenic 
      artery aneurysm (SAA) rupture, but the true rupture rate of SAAs during pregnancy 
      is unknown. Our objective was to evaluate the prevalence of SAAs, based on 
      diagnostic and procedural codes, in an urban population treated in a county 
      hospital with the highest number of births in the United States. We hypothesized 
      that SAA rupture in pregnant women is very low and that SAAs are more likely to 
      be diagnosed in older patients. METHODS: Patients diagnosed with a SAA during a 
      recent 5-year period were identified using International Classification of 
      Diseases-Ninth Edition, Clinical Modification, and Current Procedural Terminology 
      (American Medical Association, Chicago, Ill) codes. Demographics, imaging, and 
      risk factors for rupture were reviewed. RESULTS: We identified 35 patients with 
      SAA. Patients were a median age of 63 years (interquartile range [IQR], 54-74 
      years), and 28 (80%) were women who were a median age of 62 years (IQR, 54-74 
      years). The SAAs in the 35 patients were a median size of 1.3 cm (IQR, 1-1.9 cm), 
      and eight (23%) were >2 cm. Despite the very large number of deliveries recorded 
      during the study period (67,616 births), no women who were pregnant or aged <45 
      years were identified. However, 89% of women with an SAA had previous 
      pregnancies. Two women and one man (8.6%) experienced rupture, resulting in one 
      death (2.9%). More than one imaging study was available for 19 patients (60%) 
      without intervention for a median of 32 months (IQR, 7-76 months), with no 
      significant change noted. Three patients underwent elective repair due to size 
      criteria. Six patients (17%) had concurrent aneurysms, including three renal 
      artery aneurysms, one aortic aneurysm, and three intracranial aneurysms. No risk 
      factor for enlargement or rupture was particularly prevalent. CONCLUSIONS: 
      Ruptured SAAs are exceedingly rare in young women, and no ruptured SAA were 
      identified during pregnancy in this study. SAA are frequently diagnosed as an 
      incidental finding in middle-aged adults and tend to remain stable over time in 
      this population.
CI  - Copyright (c) 2014 Society for Vascular Surgery. Published by Elsevier Inc. All 
      rights reserved.
FAU - Nanez, Liliana
AU  - Nanez L
AD  - Division of Vascular and Endovascular Surgery, Department of Surgery, the 
      University of Texas Southwestern Medical Center, Dallas, Tex.
FAU - Knowles, Martyn
AU  - Knowles M
AD  - Division of Vascular and Endovascular Surgery, Department of Surgery, the 
      University of Texas Southwestern Medical Center, Dallas, Tex.
FAU - Modrall, J Gregory
AU  - Modrall JG
AD  - Division of Vascular and Endovascular Surgery, Department of Surgery, the 
      University of Texas Southwestern Medical Center, Dallas, Tex.
FAU - Valentine, R James
AU  - Valentine RJ
AD  - Division of Vascular and Endovascular Surgery, Department of Surgery, the 
      University of Texas Southwestern Medical Center, Dallas, Tex. Electronic address: 
      james.valentine@utsouthwestern.edu.
LA  - eng
PT  - Journal Article
DEP - 20141003
PL  - United States
TA  - J Vasc Surg
JT  - Journal of vascular surgery
JID - 8407742
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aneurysm, Ruptured/diagnosis/*epidemiology/mortality
MH  - Cause of Death
MH  - Female
MH  - Hospitals, County
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Parity
MH  - Pregnancy
MH  - Pregnancy Complications, Cardiovascular/diagnosis/*epidemiology/mortality
MH  - Prevalence
MH  - Retrospective Studies
MH  - Risk Factors
MH  - *Splenic Artery/diagnostic imaging
MH  - Texas/epidemiology
MH  - Time Factors
MH  - Tomography, X-Ray Computed
MH  - Urban Health
EDAT- 2014/10/06 06:00
MHDA- 2015/02/07 06:00
CRDT- 2014/10/06 06:00
PHST- 2014/07/08 00:00 [received]
PHST- 2014/08/26 00:00 [accepted]
PHST- 2014/10/06 06:00 [entrez]
PHST- 2014/10/06 06:00 [pubmed]
PHST- 2015/02/07 06:00 [medline]
AID - S0741-5214(14)01674-7 [pii]
AID - 10.1016/j.jvs.2014.08.108 [doi]
PST - ppublish
SO  - J Vasc Surg. 2014 Dec;60(6):1520-3. doi: 10.1016/j.jvs.2014.08.108. Epub 2014 Oct 
      3.