Giant splenic aneurysm repair with a staged hybrid approach

Splenic artery aneurysms (SAAs) are the most common visceral artery aneurysms. Giant SAAs (>5 cm) are rare and pose significant challenges owing to their high rupture risk and complex anatomy. We present a case of a symptomatic 18-cm SAA treated with a staged hybrid approach involving endovascular embolization of the proximal artery followed by open surgical resection and splenectomy. This approach enabled precise inflow control and minimized intraoperative bleeding, ensuring symptom resolution and complete elimination of rupture risk, thereby underscoring the value of staged management in anatomically complex giant SAAs.