Splenic Artery Embolization Blessing Or Curse? A Case Report

Splenomegaly is a common sequela of cirrhosis and is frequently associated with decreased hematologic indices including thrombocytopenia and leukopenia. Partial splenic artery embolization (PSE) has been demonstrated to effectively increase hematologic indices in cirrhotic patients with splenomegaly. This is particularly valuable amongst those cirrhotic patients who are not viable candidates for splenectomy. Although PSE was originally developed decades ago, it has recently received increased attention. Presently, PSE is being utilized to address a number of clinical concerns in the setting of cirrhosis, including decreased hematologic indices, portal hypertension, and its associated sequela, and splenic artery steal syndrome. Following PSE patients demonstrate significant increases in platelets and leukocytes. Though the progressive decline of hematologic indices occurs following PSE, they remain improved as compared to pre-procedural values over long-term follow-up. PSE, however, is not without risk, and complications of the procedure may occur. The most common complication of PSE is a post-embolization syndrome, which involves a constellation of symptoms including fever, pain, and nausea/vomiting. The rate of complications has been shown to increase as the percent of total splenic volume embolized increases.