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Transcatheter embolization of the spleen is gaining popularity as a non-surgical method of treatment for hypersplenism. While early reports documented frequent serious complications, a more recent study noted good results using a fractionated approach with only partial embolization of the periphery of the spleen. This technique was recently used on three patients with hypersplenism associated with severe liver disease. All had grave complications, including sepsis, pneumonia, abscess formation, and progressive liver failure, and all died within six weeks of the angiographic procedure in spite of good haematological responses. Since it is frequently this category of patient in whom the procedure is attempted, definitive surgical splenectomy is suggested following the embolization as soon as the clotting parameters return to normal.

The embolization of intercostal arteries for the control of massive hemoptysis is described in two patients with bronchopleural fistulas and in one patient with sarcoidosis. Hemoptysis was controlled by embolization in all three cases, but spinal cord infarction occurred in one patient as a result of the procedure. This complication can occur even in cases where no significant blood supply to the spinal cord can be seen on preliminary arteriography, which suggests that in some patients angiographically invisible small branches play an important role in the blood supply to the spinal cord. These branches may be particularly important in cases in which the spinal blood supply is already compromised by surgery, radiation therapy, or previous embolization procedures.