Comparison of total splenic artery embolization and partial splenic embolization for hypersplenism

He, Xin; Gu, Jian Jian; Li, Wen Tao; Peng, Wei; Li, Guo Dong; Wang, Sheng Ping; Xu, Lingyun; Ji, Jun Ho

doi:10.3748/wjg.v18.i24.3138

Cited by 40 publications

(26 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Hiroshi Yoshida et al [12] reported that PSE following obliteration of portal-systemic shunt reduces serum ammonia levels, and improves portal systemic encephalopathy, which might explain the result observed in our study that HE in group B did not worsen significantly, and was significantly lower than that of group A. Previous studies [6,19] demonstrated that WBC and PLT counts after PSE increased significantly than those before PSE. Consistent with these findings, patients receiving TIPS and PSE in our study had significantly increased WBC and PLT counts.…”

Section: Discussionsupporting

confidence: 74%

“…Risk factors for recurrent bleeding include an insufficient decrease in portosystemic pressure gradient after TIPS creation alone [4] . Partial splenic arterial embolization(PSE), which has been an established interventional approach for portal hypersplenism [5,6] , appears to be efficatious to in reducing episodes of variceal bleeding [7,8] , improving hematologic parameters [9,10] , enhancing hepatic protein synthesis [11] , and reducing severity of HE [12] .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Simultaneous Combined Transjugular Intrahepatic Portosystemic Shunt and Partial Splenic Embolization for Decompensated Cirrhosis

Wan

Yang

et al. 2016

Journal of Gastroenterology and Hepatology Research

View full text Add to dashboard Cite

AIM:To evaluate the efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) in combination with partial splenic arterial embolization (PSE) for cirrhotic patients with recurrent variceal bleeding and hypersplenism. METHODS: Institutional review board approval was obtained; all patients provided informed consent. From January 2010 to December 2014, a total of 141 cirrhotic patients received TIPS alone(group A, n=114) and simultaneous combined TIPS and PSE(group B, n=27) for recurrent variceal bleeding and hypersplenism secondary to portal hypertension. The TIPS was created by using covered stents. All patients underwent embolotherapy via the jugular vein after TIPS implantation. Patients in group B (n=27) received simultaneous PSE after creation of TIPS. Biochemical tests, coagulation function, complete blood cell (CBC) counts, frequencies of recurrent variceal bleeding and hepatic encephalopathy (HE), and survival were evaluated. Model for end stage liver diseases (MELD) scores were calculated. RESULTS: TIPS creation was successful in all patients. After the treatments, patients in group B had better hepatic synthetic function, increased levels of white blood cells (WBC), platelets (PLT), and hemoglobin(HGB), lower frequency of HE, lower overall and cirrhosis-related mortality than patients in group A (P<0.05), though the two groups had similar recurrent variceal bleeding frequency (P>0.05). Multivariate analysis showed that MELD scores, HE, and group were independent factors for overall and liver-related mortality at month 24 (P<0.05). No severe complications were observed in the two groups. CONCLUSIONS: Simultaneous combined TIPS and PSE regimen improves hematologic parameters, prevents deterioration of liver function and coagulation function, reduces variceal bleeding and HE, thus reduces mortality.

show abstract

Section: Discussionsupporting

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Simultaneous Combined Transjugular Intrahepatic Portosystemic Shunt and Partial Splenic Embolization for Decompensated Cirrhosis

Wan

Yang

et al. 2016

Journal of Gastroenterology and Hepatology Research

View full text Add to dashboard Cite

show abstract

“…On the Other hand; He et al. , performed PSE for 34 patients with hypersplenism and reported 100% technical success.…”

Section: Discussionmentioning

confidence: 99%

Portal and splanchnic hemodynamics after partial splenic embolization in cirrhotic patients with hypersplenism

Helaly

Alwarraky

El-Azab

et al. 2015

APMIS

View full text Add to dashboard Cite

To assess the acute effects of partial splenic embolization (PSE) on portal and splanchnic hemodynamics in patients with cirrhosis. Ninety-five patients with hypersplenism were included in the study. Duplex examinations were performed before and 3 and 7 days after PSE. Portal and splanchnic hemodynamics including vessel cross-sectional area (CSA), mean flow velocities (cm/s), blood flows (mL/min), Doppler indices as portal congestion index (CI), liver vascular index, hepatic artery and superior mesenteric artery (SMA) pulsatility and resistive indices (PI and RI), were performed before and after PSE. In our study, 69 of 95 patients were males (72.6%) and 26 females (27.3%). Chronic hepatitis C virus infection was the main cause of cirrhosis (81.1%). PSE failed technically in six patients (6.3%). After PSE, both CSA and CI significantly decreased (p < 0.05 and <0.01). The portal vein velocity significantly increased (p < 0.01). The portal flow volume (892.4 ± 151 mL/min) did not show significant changes. The hepatic artery RI and PI showed a steady increase that became significant 7 days post-PSE (p < 0.05). The RI and PI of SMA increased significantly after 7 days of PSE (p < 0.05). PSE has an immediate portal decompression effect in patients with portal hypertension without reduction in portal flow. This effect on portal pressure should be investigated in future studies as a potential tool for management of acute variceal bleeding when other medical procedures fail.

show abstract

“…The potential complications include post-embolisation syndrome, splenic abscess, splenic rupture, refractory ascites, distal pancreatitis and gastrointenstinal bleeding 5 6. Pulmonary disorders, such as pneumonia, atelectasis and pleural effusions, are the other potential complications, which usually develop in the left lung and are associated with embolisation of the upper pole of the spleen 4.…”

Section: Discussionmentioning

confidence: 99%

Severe thrombocytopenia due to hypersplenism treated with partial splenic embolisation

et al. 2013

View full text Add to dashboard Cite

A 35-year-old woman with background of liver cirrhosis and portal hypertension secondary to chronic hepatitis C presented with complication of hypersplenism and thrombocytopenia. She developed severe menorrhagia requiring multiple blood transfusions. In addition, her interferon therapy was withheld owing to the underlying thrombocytopenia. Partial splenic embolisation was performed, which improved her platelet counts. Subsequently, the menorrhagia was resolved and her interferon therapy was restarted.

show abstract

Comparison of total splenic artery embolization and partial splenic embolization for hypersplenism

Abstract: Our results indicate that TSAE for patients with hypersplenism not only delivers a better long-term outcome, but is also associated with lower complication rates and a shorter hospital stay than PSE.

Cited by 40 publications

References 19 publications

Simultaneous Combined Transjugular Intrahepatic Portosystemic Shunt and Partial Splenic Embolization for Decompensated Cirrhosis

Simultaneous Combined Transjugular Intrahepatic Portosystemic Shunt and Partial Splenic Embolization for Decompensated Cirrhosis

Portal and splanchnic hemodynamics after partial splenic embolization in cirrhotic patients with hypersplenism

Severe thrombocytopenia due to hypersplenism treated with partial splenic embolisation

Contact Info

Product

Resources

About