A coaxial technique was introduced for successful embolization of a large fusiform splenic artery aneurysm in a vessel with a large caliber and a great degree of tortuosity. A standard 5-F angioplasty catheter was placed at the immediate afferent artery for occlusion of arterial inflow into the aneurysm, thereby preventing intraaneurysmal hypertension during embolization of the efferent segment. This was followed by coaxial microcatheterization of the immediate efferent segment for coil embolization, and then embolization of the afferent segment. It is postulated that this approach may improve the safety of embolization of large aneurysms with unfavorable morphology by decreasing the pressure on the aneurysm just after closure of the efferent segment.
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