A retrospective multi-centre study of splenic volumes measured by CT following splenic artery angioembolisation for high-grade blunt splenic injuries in adults

Introduction Splenic artery embolisation is a recognised modality in the management of high grade blunt splenic injury. The impact of embolisation on the spleen in terms of volume and function remains unclear. This results in a lack of clarity regarding post embolisation vaccination policy. Methods This was a two-centre, retrospective observational study over a 24-month period involving all patients who underwent splenic artery embolisation for high grade blunt splenic trauma (AAST grades III-V). Splenic volumes were calculated from an initial CT and a repeat CT at 6 months post embolisation. Subgroup analysis was performed analysing the location of embolisation, AAST grading, and evidence of splenic dysfunction as defined by the presence of altered red cell morphology. Results Thirty patients achieved successful splenic salvage with angioembolisation. Mean volume loss was 44.14 cm(3) (P = 0.038), with decreased volumes for distal embolisation and increased volumes for proximal embolisation. Three patients had altered red cell morphology; two demonstrated recovery at 6 months, with the third lost to follow up. There were significant associations between, initial splenic volume, AAST grade of injury, and altered red cell morphology. There was no significant association between location of embolisation, initial splenic volumes, or percentage volume change. Conclusion This study demonstrated a statistically significant change in splenic volume post angioembolisation in trauma, which was associated with AAST grading but not location of embolisation. The low rate of altered red cell morphology appears transient.