Abstract
Purpose:To assess the safety and efficacy of main splenic artery embolization. To assess the potential difference post-embolization of the residual splenic volume in patients embolized for trauma versus those embolized for (pseudo)aneurysms.Materials and Methods:A retrospective analysis was performed on a cohort of 65 patients (36 males) who underwent pre- and post-embolization computed tomography. Patients’ demographics, pre- and post-interventional medical and radiological data were gathered. Splenic volume calculations were semi-automatically performed via a workstation. Patients with splenic aneurysms or pseudoaneurysms of the main splenic artery (group 1) were compared to those with splenic rupture (group 2) using Wilcoxon rank tests.Results:The main indications for splenic artery embolization were splenic rupture (n = 22; 34%) and splenic pseudoaneurysm (n = 19; 29%). The technical success rate was n = 63; 97%. The procedure-related complication rate was n = 7; 11%, including abscess formation (n = 5; 8%), re-bleeding (n = 1; 1.5 %) and pseudoaneurysm re-opening (n = 1; 1.5%). The overall 30-day mortality was n = 7; 11%.Median follow-up for groups 1 and 2 was 1163 days (61–3946 days) and 702 days (43–2095 days) respectively. When processable (n = 23), the splenic volume in group 1 (n = 7) was 311 cm3 and 257 cm3 (p = 0.1591) before and after embolization respectively, and in group 2 (n = 16) it was 261 cm3 and 215 cm3 (p = 0.4688), respectively.Conclusions:Main splenic artery embolization is efficacious, with low procedure-related complication and 30-day mortality rates. No significant differences in residual post-embolization splenic volume were found between patients treated for splenic rupture versus those treated for splenic arterial (pseudo)aneurysm.
Highlights
No significant differences in residual post-embolization splenic volume were found between patients treated for splenic rupture versus those treated for splenic arterialaneurysm
A variety of clinical disorders, including focal lesions of the main splenic artery and splenic parenchymal disorders can be managed by catheter-directed splenic artery embolization (SAE) as an alternative to surgical splenectomy [1]
Main splenic artery coil-embolization can preserve substantial residual splenic tissue and function [2, 3], which may result in a better long-term clinical outcome
Summary
A variety of clinical disorders, including focal lesions of the main splenic artery and splenic parenchymal disorders can be managed by catheter-directed splenic artery embolization (SAE) as an alternative to surgical splenectomy [1]. Main splenic artery coil-embolization can preserve substantial residual splenic tissue and function [2, 3], which may result in a better long-term clinical outcome. The anatomical and physiological mechanism for preservation of splenic parenchyma and function after coil-embolization is related to the rich collateral arterial supply from various branches, including left gastric, left gastroepiploic, and pancreatic branches to the distal main splenic artery and the first branches. We hypothesized that splenic volume reduction after main splenic artery embolization would not be influenced by the underlying disease. Safety and efficacy of main splenic artery embolization for various indications is analyzed in this study, along with post-embolization splenic volume changes in patients embolized for splenic trauma versus those embolized for main splenic artery (pseudo)aneurysm
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