Case Report of Splenic Artery Steal Syndrome: Demonstration of Portal Hyperflow Mechanism by Anatomic Variant of the Splenic Artery and Correlation With Doppler Rates

Pérez, J R Costa; Grande, Luís; Achécar, L.; Moreno, Alberto; Fortün, Jesús; Arranz, G.; Tejedor, Marta; Blázquez, Javier; Sánchez, Juan; Pián, Héctor; Bárcena, Rafael

doi:10.1016/j.transproceed.2011.05.022

Cited by 7 publications

(11 citation statements)

References 5 publications

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“…Currently, the available treatments, preventive, or curative, for SASS can vary from the interventional radiologic treatment (proximal coil embolization, Amplatzer vascular plug or intra-arterial papaverine infusion) to surgical ones, including splenic artery ligation or banding and splenectomy. Despite all these possibilities, most of the literature seems to prefer splenic artery proximal embolization for its minimally invasive approach, avoiding a surgical procedure that, in the case of intraoperative splenectomy or ligation of the splenic artery, could require an extended dissection area, increasing the risk of intra-and postoperative bleeding [1,3,[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Splenic artery proximal embolization is defined as an embolization distal to the dorsal pancreatic artery (the first large branch) and proximal to the peripheral pancreatic magna artery (the second large branch).…”

Section: Discussionmentioning

confidence: 99%

Splenic artery steal syndrome after liver transplantation – prophylaxis or treatment?: A case report and literature review

Usai

Colasanti

Meniconi

et al. 2022

Ann Hepatobiliary Pancreat Surg

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Splenic artery steal syndrome (SASS) is a cause of graft hypoperfusion leading to the development of biliary tract complications, graft failure, and in some cases to retransplantation. Its management is still controversial since there is no universal consensus about its prophylaxis and consequently treatment. We present a case of SASS that occurred 48 hours after orthotopic liver transplantation (OLTx) in a 56-year-old male patient with alcoholic cirrhosis and severe portal hypertension, and who was successfully treated by splenic artery embolization. A literature search was performed using the PubMed database, and a total of 22 studies including 4,789 patients who underwent OLTx were relevant to this review. A prophylactic treatment was performed in 260 cases (6.2%) through splenic artery ligation in 98 patients (37.7%) and splenic artery banding in 102 (39.2%). In the patients who did not receive prophylaxis, SASS occurred after OLTx in 266 (5.5%) and was mainly treated by splenic artery embolization (78.9%). Splenic artery ligation and splenectomies were performed, respectively, in 6 and 20 patients (2.3% and 7.5%). The higher rate of complications registered was represented by biliary tract complications (9.7% in patients who received prophylaxis and 11.6% in patients who developed SASS), portal vein thrombosis (respectively, 7.3% and 6.9%), splenectomy (4.8% and 20.9%), and death from sepsis (4.8% and 30.2%). Whenever possible, prevention is the best way to approach SASS, considering all the potential damage arising from an arterial graft hypoperfusion. Where clinical conditions do not permit prophylaxis, an accurate risk assessment and postoperative monitoring are mandatory.

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Section: Discussionmentioning

confidence: 99%

Splenic artery steal syndrome after liver transplantation – prophylaxis or treatment?: A case report and literature review

Usai

Colasanti

Meniconi

et al. 2022

Ann Hepatobiliary Pancreat Surg

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Section: Discussionmentioning

confidence: 99%

“…Doppler sonography has been reported to be useful for the follow‐up of patients with splenic steal syndrome after splenic artery embolization 8 , 9 , 11 . In these studies, patients who underwent splenic artery embolization had a significant decrease in the hepatic arterial RI compared with pretreatment levels 8 , 9 , 11 . Increases in hepatic arterial velocities 11 and decreases in PVV values were also reported in patients with splenic steal syndrome who were treated with splenic artery embolization 8 , 9 , 11 .…”

Section: Discussionmentioning

confidence: 99%

“…In these studies, patients who underwent splenic artery embolization had a significant decrease in the hepatic arterial RI compared with pretreatment levels 8 , 9 , 11 . Increases in hepatic arterial velocities 11 and decreases in PVV values were also reported in patients with splenic steal syndrome who were treated with splenic artery embolization 8 , 9 , 11 . Our study confirmed these decreases in RI and PVV levels in patients with splenic steal syndrome who underwent splenic artery embolization, but we observed no significant increase in hepatic arterial velocities.…”

Section: Discussionmentioning

confidence: 99%

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Role of Doppler Sonography in Early Detection of Splenic Steal Syndrome

Quintini

Hashimoto

et al. 2016

J of Ultrasound Medicine

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“…112,113 Patients with splenic steal syndrome may present with elevated liver function tests, and this condition is occasionally associated with thrombocytopenia, cholestasis, ascites, and graft failure. [114][115][116][117] Left untreated, splenic steal syndrome can progress to graft failure. 117 Proximal splenic arterial embolization can be an effective treatment for this condition, with immediate improvement of hepatic flow and minimal risk.…”

Section: Hepatic Artery Complicationsmentioning

confidence: 99%

Iatrogenic-Related Transplant Injuries: The Role of the Interventional Radiologist

Copelan

George

Kapoor

et al. 2015

Semin intervent Radiol

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As advances in surgical techniques and postoperative care continue to improve outcomes, the use of solid organ transplants as a treatment for end-stage organ disease is increasing. With the growing population of transplant patients, there is an increasing need for radiologic diagnosis and minimally invasive procedures for the management of posttransplant complications. Typical complications may be vascular or nonvascular. Vascular complications include arterial stenosis, graft thrombosis, and development of fistulae. Common nonvascular complications consist of leaks, abscess formation, and stricture development. The use of interventional radiology in the management of these problems has led to better graft survival and lower patient morbidity and mortality. An understanding of surgical techniques, postoperative anatomy, radiologic findings, and management options for complications is critical for proficient management of complex transplant cases. This article reviews these factors for kidney, liver, pancreas, islet cell, lung, and small bowel transplants.

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Case Report of Splenic Artery Steal Syndrome: Demonstration of Portal Hyperflow Mechanism by Anatomic Variant of the Splenic Artery and Correlation With Doppler Rates

Cited by 7 publications

References 5 publications

Splenic artery steal syndrome after liver transplantation – prophylaxis or treatment?: A case report and literature review

Splenic artery steal syndrome after liver transplantation – prophylaxis or treatment?: A case report and literature review

Role of Doppler Sonography in Early Detection of Splenic Steal Syndrome

Iatrogenic-Related Transplant Injuries: The Role of the Interventional Radiologist

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