Coil Embolization of the Splenic Artery: Impact on Splenic Volume

Abstract

PurposeTo determine the impact of coil embolization of the splenic artery on splenic volume based on computed tomography (CT) imaging. Materials and MethodsSplenic artery embolization (SAE) was performed in 148 consecutive patients over an 8-year period in an institutional review board–approved retrospective study. Of these, 60 patients (36 men; mean age, 49 y) had undergone contrast-enhanced CT before and after SAE with a mean time interval of 355 days. Pre- and postembolization splenic volumes were calculated with volume-rendering software. Presence of Howell–Jolly bodies was ascertained on laboratory tests. A trauma control group consisted of 39 patients with splenic laceration and follow-up CT but no splenic intervention. ResultsSAE in trauma patients resulted in an insignificant decrease in mean spleen size from 224 cm3 to 190 cm3 (P = .222). However, postembolization splenic volume was significantly smaller than follow-up volume in the trauma control group (353 cm3; P < .001). In nontrauma patients, the mean splenic volume decreased from 474 cm3 to 399 cm3 after SAE (P = .068). Multivariable analysis revealed that coil pack location was the only factor significantly affecting resultant splenic volume (P = .016). For trauma and nontrauma patients, distal embolization resulted in significant splenic volume loss (P = .034 and P = .013), whereas proximal embolization did not. No patients had persistent circulating Howell–Jolly bodies after SAE. No patients required repeat embolization or splenectomy. ConclusionsCoil embolization of the splenic artery resulted in a modest but significant decrease in splenic volume when performed distally; proximal embolization resulted in an insignificant volume change.