A novel method for the angiographic estimation of the percentage of spleen volume embolized during partial splenic embolization

Ou, Ming Ching; Chuang, Ming Tsung; Lin, Xi Zhang; Tsai, Hann-Huei; Chen, Shu Yuan; Liu, Yi Sheng

doi:10.1016/j.ejrad.2013.01.013

Cited by 8 publications

(6 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Now, partial SAE has become a nonsurgical alternative for cirrhotic patients with hypersplenism who are not indicated for surgical treatment. 17 Many recent studies have shown that partial SAE is effective and is associated with substantially lower morbidity, complications and mortality. 18,19 So far, few studies have focused on the post-SAE complications.…”

Section: Discussionmentioning

confidence: 99%

<p>Severe Complications After Splenic Artery Embolization for Portal Hypertension Due to Hepatic Cirrhosis</p>

Zhang¹,

Zhang²,

Long³

et al. 2020

RMHP

View full text Add to dashboard Cite

Background: Splenomegaly/hypersplenism is one of the most common complications of portal hypertension. Splenic artery embolization (SAE) has been increasingly used for treatment of splenomegaly/hypersplenism. However, few studies focused on the severe complications after embolization. In this paper, we reported 16 cases of severe complications after SAE for portal hypertension. Methods: From February 2011 to January 2019, 16 cirrhotic patients were diagnosed with severe complications after embolization. The clinical symptoms, therapies and prognosis were analyzed. Results: In these patients, the splenic embolization volume was between 50% and 70%. Among 16 cases, 7 patients were diagnosed with splenic abscess and/or left subphrenic abscess, suffered from the insistent fever, and eventually underwent the surgical therapy; 6 patients with left refractory pleural effusion, suffered from severe chest distress, and underwent repeated thoracocentesis or thoracic closed drainage; 3 patients with thrombosis in portal vein needed oral warfarin therapy. Conclusion: In cirrhotic patients, the severe complications after SAE are not uncommon after the procedure. It causes more suffering, prolonged hospital stay and more medical cost in these patients. It was debatable whether this technique was an appropriate technique for portal hypertension due to liver cirrhosis, patients contraindicated for the treatment should be carefully identified to avoid the complications.

show abstract

Section: Discussionmentioning

confidence: 99%

<p>Severe Complications After Splenic Artery Embolization for Portal Hypertension Due to Hepatic Cirrhosis</p>

Zhang¹,

Zhang²,

Long³

et al. 2020

RMHP

View full text Add to dashboard Cite

show abstract

“…It is very difficult, however, to assign the target area prior to an actual injection. Ming Ching reported that the diameter of a branch of splenic artery was positively correlated with the volume of the corresponding parenchyma of the spleen [ 24 ]. Consistently, the diameter of the target HV may be correlated with the target volume.…”

Section: Resultsmentioning

confidence: 99%

Site-Specific Impact of a Regional Hydrodynamic Injection: Computed Tomography Study during Hydrodynamic Injection Targeting the Swine Liver

et al. 2015

View full text Add to dashboard Cite

A hemodynamic study of hydrodynamic gene delivery (HGD) from the tail vein in rodents has inspired a mechanism and an approach to further improve the efficacy of this procedure. However, there is no report on the hemodynamics of a regional HGD, which is an inevitable approach in large animals. Here, we report the hemodynamics of a regional hydrodynamic injection in detail based on 3D volume data and the dynamism of tissue intensity over time by using computed tomography (CT) both during and after a regional hydrodynamic injection that targeted the liver of a pig weighing 15.6 kg. Contrast medium (CM) was injected at a steady speed of 20 mL/s for 7.5 s under the temporal balloon occlusion of the hepatic vein (HV). A retrograde flow formed a wedge-shaped strong enhancement area downstream of the corresponding HV within 2.5 s, which was followed by drainage into another HV beginning from the target area and the portal vein (PV) toward a non-target area of the liver. After the injection, the CM was readily eliminated from the PV outside the target area. These data suggest that an interventional radiology approach is effective in limiting the hydrodynamic impacts in large animals at a target area and that the burden overflowing into the PV is limited. A further investigation that simultaneously evaluates gene delivery efficiency and hemodynamics using CT is needed to establish feasible parameters for a regional HGD in large animals.

show abstract

“…Toru Ishikawa et al [30] found that the splenic embolization ratio measurement obtained via cone beam CTA can be used to assess PSE treatment endpoints. Ming-Ching Ou et al [31] reported that Estimated splenic embolization volume was calculated by a method based on diameters of the splenic artery and its branches which were measured via 2D angiographic images, the method provides a simple method to quantitatively estimate embolized splenic volume. Jun Koizumi et al [32] found that the use of diffusion-weighted imaging (DWI) for estimating infarcted splenic volume during partial splenic embolisation (PSE) allowed semi-automated splenic volumetry on site.…”

Section: Discussionmentioning

confidence: 99%

Quantitative splenic embolization possible: application of 8Spheres conformal microspheres in partial splenic embolization (PSE)

Zheng

Liang

et al. 2021

BMC Gastroenterol

View full text Add to dashboard Cite

Background To investigate the safety and efficacy of 8Spheres in partial splenic embolization. To explore the possibility of accurate control of splenic embolic volume by quantifying the number of microspheres used during PSE. Method The data of 179 patients who underwent PSE were collected. The patients were divided into two groups: 300–500 um microsphere group (N = 83) and 500–700 um microsphere group (N = 96). The spleen volume before PSE, infarct volume and infarct rate of the spleen after PSE, changes in peripheral blood cells after PSE, postoperative adverse events and incidence of infection were compared between the two groups. Results 300–500 um group vs 500–700 um group: postoperative spleen volume (cm3): 753.82 ± 325.41 vs 568.65 ± 298.16 (P = 0.008); spleen embolization volume (cm3): 525.93 ± 118.29 vs 630.26 ± 109.71 (P = 0.014); spleen embolization rate: 41.1 ± 12.3% vs 52.4 ± 10.1% (P = 0.021). Leukocytes and platelets were significantly increased after PSE in both groups; leukocyte, 1 month: 4.13 ± 0.91 vs 5.08 ± 1.16 (P = 0.026); 3 months: 4.08 ± 1.25 vs 4.83 ± 0.98 (P = 0.022); platelet, 1 month: 125.6 ± 20.3 vs 138.7 ± 18.4 (P = 0.019); 3 months: 121.8 ± 16.9 vs 134.3 ± 20.1 (P = 0.017). Incidence of abdominal pain after PSE, 72 (86.7%) vs 69 (71.9%), P = 0.027. The incidence of other adverse events and infections after PSE was not statistically different. Conclusion PSE with 8Spheres is safe and effective. The use of 500–700 um microsphere for PSE can make the increase of peripheral blood cells more stable. Each vial of 8Spheres corresponds to a certain volume of splenic embolization, so it is possible to achieve quantitative embolization in PSE.

show abstract

A novel method for the angiographic estimation of the percentage of spleen volume embolized during partial splenic embolization

Cited by 8 publications

References 17 publications

<p>Severe Complications After Splenic Artery Embolization for Portal Hypertension Due to Hepatic Cirrhosis</p>

<p>Severe Complications After Splenic Artery Embolization for Portal Hypertension Due to Hepatic Cirrhosis</p>

Site-Specific Impact of a Regional Hydrodynamic Injection: Computed Tomography Study during Hydrodynamic Injection Targeting the Swine Liver

Quantitative splenic embolization possible: application of 8Spheres conformal microspheres in partial splenic embolization (PSE)

Contact Info

Product

Resources

About