Partial splenic artery embolization: an alternative management strategy for resistant thrombocytopenia of immune thrombocytopenic purpura (ITP)

Dissanayake, L. K.; Hewavithana, P. B.; Rathnayake, R. M. P.; Pethiyagoda, Aub

doi:10.4038/sljm.v27i1.80

Cited by 2 publications

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“…In addition, SE has been successfully applied to treat refractoriness to RBC transfusion secondary to hypersplenism, potentially predicting the utility of subsequent splenectomy 66–68 . Furthermore, though not included in the analysis of effectiveness, we identified 11 citations that described the successful use of SE in young and adult patients with ITP who were considered unsuitable candidates for splenectomy, 16,17,41,42,44,69–72 declined surgery 73 or individuals who experienced ITP relapse post‐splenectomy due to accessory spleen 74,75 …”

Section: Discussionmentioning

confidence: 99%

“…[22][23][24][25][26][27][28][29][30][31][32][33]65 In addition, SE has been successfully applied to treat refractoriness to RBC transfusion secondary to hypersplenism, potentially predicting the utility of subsequent splenectomy. [66][67][68] Furthermore, though not included in the analysis of effectiveness, we identified 11 citations that described the successful use of SE in young and adult patients with ITP who were considered unsuitable candidates for splenectomy, 16,17,41,42,44,[69][70][71][72] declined surgery 73 or individuals who experienced ITP relapse post-splenectomy due to accessory spleen. 74,75 Like SE, splenic irradiation has also been extensively described as a viable alternative to splenectomy in patients with massive splenomegaly leading to debilitating symptoms with severe cytopenias, and who are not suitable candidates for surgery.…”

Section: Study Year (Reference)mentioning

confidence: 99%

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The use of splenic embolization in immune thrombocytopenia: A systematic review and meta‐analysis

Egbaria,

Touma,

Cohen‐Abadi

et al. 2024

Br J Haematol

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SummaryThe effectiveness of splenic embolization (SE) in treating refractory immune thrombocytopenia (ITP) remains uncertain. A systematic literature review was undertaken to assess the effectiveness and safety of SE in treating both paediatric and adult patients with ITP. We conducted an extensive search employing predefined criteria. We extracted platelet counts at baseline and at multiple intervals following SE, along with details of the proportion of embolized spleen parenchyma and the proportion of patients exhibiting complete or partial platelet count responses. We identified nine eligible reports for the analysis of effectiveness (228 patients) and 15 reports for the safety analysis (151 patients). Pooled estimates of complete response (platelet count >100 × 109/L) and overall response (platelet count >30 × 109/L) were 50.1% (95% CI: 38–62.3) and 74.4% (95% CI: 64.9–83.9) respectively. Most studies applied an embolization of at least 60% of the spleen parenchyma. Nearly all the patients suffered from mild adverse events (AEs), 1.3% suffered from serious AEs and one patient died (0.7%). In conclusion, SE resulted in an overall response rate in 74.4% of patients with ITP. However, this finding derives from uncontrolled studies of low to moderate quality.

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Section: Discussionmentioning

confidence: 99%

Section: Study Year (Reference)mentioning

confidence: 99%

The use of splenic embolization in immune thrombocytopenia: A systematic review and meta‐analysis

Egbaria,

Touma,

Cohen‐Abadi

et al. 2024

Br J Haematol

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Partial splenic artery embolization (PSE) in a patient with grey platelet syndrome (GPS): a case report

Zaitoun

Abdullah

Zaitoun

et al. 2022

Egypt J Radiol Nucl Med

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Background Grey platelet syndrome (GPS) is a rare cause of mild-to-severe bleeding. Up till now, there has been no definite treatment for GPS. Case presentation We reported a case diagnosed as GPS and presented with menorrhagia, metrorrhagia, gingival bleeding, and left hypochondrial pain. The platelet count was 18 thousand/cmm. Ultrasound splenic diameter was 22.0 cm. The multidisciplinary team decided to perform splenectomy; however, the patient was unfit for surgery. Partial splenic artery embolization (PSE) was performed. Follow-up after 24 months showed a normal menstrual cycle and absent pain. Platelet count rise to 70, 55, and 51 thousand/cmm after 1, 12, and 24 months, respectively. Splenic diameter showed a significant decrease to 11.2 cm after 24 months. Conclusion PSE is effective and safe in symptomatic patients with GPS.

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Partial splenic artery embolization: an alternative management strategy for resistant thrombocytopenia of immune thrombocytopenic purpura (ITP)

Abstract: This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY)

Cited by 2 publications

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The use of splenic embolization in immune thrombocytopenia: A systematic review and meta‐analysis

The use of splenic embolization in immune thrombocytopenia: A systematic review and meta‐analysis

Partial splenic artery embolization (PSE) in a patient with grey platelet syndrome (GPS): a case report

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