Splenic artery embolization: a single center experience on the safety, efficacy, and clinical outcomes

PURPOSE We aimed to assess the safety, efficacy, and clinical outcomes; of splenic artery embolization (SAE). MATERIALS AND METHODS A total of 50 patients (male:female, 33:17; mean age, 49 years) who underwent 50 SAEs between 1 998 and 2011 were retrospectively studied. The procedure indications included aneurysm or pseudoaneurysm (n=15), gastric variceal hemorrhage (n=15), preoperative reduction of surgical blood loss; (n=9), or other (n=11). In total, 22 procedures were elective,; and 28 procedures were urgent or emergent. The embolic, agents included coils (n=50), gelatin sponges (n=15), and particles (n=4). The measured outcomes were the technical success of the procedure, efficacy, side effects, and the 30-day morbidity and mortality rates. RESULTS All embolizations were technically successful. The procedure efficacy was 90%; five patients (10%) had a recurrent hemorrhage requiring a secondary intervention. Side effects included hydrothorax (n=26, 52%), thrombocytosis (n=16, 32%), thrombocytopenia(n=13, 26%), and postembolization syndrome (n=11, 22%). Splenic infarcts occurred in 13 patients (26%). The overall and procedure-specific 30-day Morbidity; rates were 38% (19/50 and 14% (splenoportal thrombosis, 3/50; encapsulated bacterial infection, 1/50; splenic-abscess, 1/50; femoral hematoma requiring surgery, 1/50; hydrothorax requiring,drainage; 1/50). The overall and procedure-specific 30-day mortality rates were 8% (4/50) and %. The multivariate analysis showed that advanced patient-age (P = 0.037), postprocedure thrombocytopenia (P = 0.008), postprocedure hydrothorax (P = 0.009), and the need for a secondary intervention(P=0.004) predicted the 30-day : morbidity, while renal insufficiency (P < 0.0001), preprocedure hemodynamic instability (P = 0.044), and preprocedure leukocytosis (P < 0.0001) Wire prognostic factors for the 30-day, mortality. CONCLUSION SAE was performed with high technical success:and efficacy, but the outcomes showed nontrivial morbidity rates. Elderly patients with thrombocytopenia and hydrothorax after SAE. and patients Who require secondary interventions, should be monitored for complications.