45 year old female patient who presents with ill-defined abdominal pain. A CT demonstrated a splenic artery aneurysm. Treatment was attempted from a femoral approach but the tortuosity of the splenic artery made it impossible to maintain a stable catheter position. As a result, radial access was obtained, and embolization was ultimately performed with multiple detachable coils.
Comment: This case demonstrates the importance of choosing the most appropriate access site given the demands of the procedure. In this case, the angle of the celiac axis favored a radial approach. By placing the sheath from a radial approach, the system was stable until the first curve of the celiac axis. The presence of the sheath enabled us to push the microcatheter forward in the splenic artery without buckling the sheath into the aorta. Ultimately, the microcatheter was advanced until it coiled within the aneurysm. Care was taken while embolizing to keep the coils more towards the inferior aspect of the aneurysm sac to maintain patency of the vessel arising from the apex of the aneurysm.