Splenic Artery Embolization in Blunt Trauma

Abstract

In prior decades, splenic arterial embolization (SAE) was used increasingly in the setting of nonoperative management of blunt splenic trauma. Recently, however, multiple studies have questioned the efficacy of SAE in the blunt trauma population; at the very least, the clinical indications for SAE appear to be changing.1 At many institutions, however, including ours, SAE remains a mainstay in the treatment of patients suffering blunt trauma to the spleen. Although there is evidence that in certain patient populations SAE improves outcome, the superiority of a specific technique (proximal embolization, distal embolization, or a combination of both) is still debated. This article briefly reviews indications, general techniques, and complications of SAE; specific attention is paid to our preferred technique for SAE, with an emphasis on the distinction between proximal and distal embolization.