Abstract No. 396 Partial splenic artery embolization: a nonsurgical approach to hypersplenism

Abstract

Partial splenic embolization (PSE) is a novel percutaneous interventional method and an alternative to open and laparoscopic splenectomy because of its minimally invasive nature and fewer complications. PSE can be particularly useful in high-risk surgical patients allowing preservation normal splenic function and thus avoiding the risk of infections. Retrospective study of 14 patients (8 males and 6 females) in the age group of 10 to 49 years with hypersplenism (massive splenomegaly and Platelet count 10000-60000) referred to IR department for partial splenic artery embolization between October 2013 and October 2018. Baseline data was documented. PSE was performed though transfemoral approach using PVA Particles (355 to 500 microns) sparing one or two sectors to retain 20- 30% of the blood supply and to achieve ∼70% splenic infarction. Intra-arterial gentamycin was given to all patients after splenic artery catheterization. Follow-up for splenic size and complete blood counts were done at one month and six months post procedure and were analyzed. All patients achieved a splenic infarction rate of more than 50% with a significant improvement in platelet count. All patients had a well-maintained splenic function. Post-embolization syndrome was noted in 8 patients which was managed conservatively. There were no major complications identified in any of the patients PSE is a safe and minimally invasive technique having a good long-term effect on the hematological parameters, minimal complications and preservation of normal splenic function.