Partial splenic embolization for hypersplenism in renal transplantation

Aj, Gerlock; Rc, MacDonell; Muhletaler, CA; Wc, Parris; Hk, Johnson; Mb, Tallent; Re, Richie; Kendall, RI

doi:10.2214/ajr.138.3.451

Cited by 17 publications

(5 citation statements)

References 8 publications

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“…This occurred only in the patient with an upper pole infarction. Romano and associates [9] reported the same complication, whereas Gerlock and colleagues [25] found that no patients developed pleural effusion.…”

Section: Discussionmentioning

confidence: 98%

Partial Splenic Embolization Versus Splenectomy for the Management of Hypersplenism in Cirrhotic Patients

et al. 2009

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Section: Discussionmentioning

confidence: 98%

Partial Splenic Embolization Versus Splenectomy for the Management of Hypersplenism in Cirrhotic Patients

et al. 2009

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“…Patients who have comorbid conditions and severe cytopenia may not be considered candidates for this surgery. However, the removal of functional splenic tissue may improve hematologic abnormalities related to bone marrow suppression from systemic chemotherapeutic and immunosuppressive agents, so that optimal doses of such medications can be maintained (32,33). Transverse contrast-enhanced CT scan obtained at follow-up shows a coil within the splenic artery (arrow), as well as complete infarction of the spleen, which is not contrast enhanced.…”

Section: Rationale For Partial Embolizationmentioning

confidence: 99%

Splenic Arterial Interventions: Anatomy, Indications, Technical Considerations, and Potential Complications

Madoff

Denys

Wallace³

et al. 2005

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Splenic arterial interventions are increasingly performed to treat various clinical conditions, including abdominal trauma, hypersplenism, splenic arterial aneurysm, portal hypertension, and splenic neoplasm. When clinically appropriate, these procedures may provide an alternative to open surgery. They may help to salvage splenic function in patients with posttraumatic injuries or hypersplenism and to improve hematologic parameters in those who otherwise would be unable to undergo high-dose chemotherapy or immunosuppressive therapy. Splenic arterial interventions also may be performed to exclude splenic artery aneurysms from the parent vessel lumen and prevent aneurysm rupture; to reduce portal pressure and prevent sequelae in patients with portal hypertension; to treat splenic artery steal syndrome and improve liver perfusion in liver transplant recipients; and to administer targeted treatment to areas of neoplastic disease in the splenic parenchyma. As the use of splenic arterial interventions increases in interventional radiology practice, clinicians must be familiar with the splenic vascular anatomy, the indications and contraindications for performing interventional procedures, the technical considerations involved, and the potential use of other interventional procedures, such as radiofrequency ablation, in combination with splenic arterial interventions. Familiarity with the complications that can result from these interventional procedures, including abscess formation and pancreatitis, also is important.

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“…For these reasons, total splenic embolization is not used as a therapeutic tool in place of splenectomy. Nevertheless, partial splenic embolization (PSE) has produced a partial or total response in the underlying cytopenia of various hematologic disorders causing hypersplenism [1,7,23]. More recently, it has been used to manage selected cases of splenic trauma [8,21].…”

mentioning

confidence: 99%

Splenic artery embolization before laparoscopic splenectomy An update

1998

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Preoperative splenic artery embolization is not necessary for spleens shorter than 20 cm. Increased experience and mostly the lateral surgical approach have permitted a shorter operation and a low conversion rate (4%) similar to the rate achieved with embolization and the anterior approach in the initial stages of the study. Embolization is used for 20- to 30-cm spleens. The conversion rate is higher (17%), and blood replacement is required frequently (83%). Despite embolization, laparoscopic splenectomy for spleens longer than 30 cm is futile at this time (100% conversion).

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Partial splenic embolization for hypersplenism in renal transplantation

Abstract: Schoolof Medicine and Hospital, 21st and Garland Ave., Nashville, TN 37232. Address reprint requests to C. A.Muhletaler.

Cited by 17 publications

References 8 publications

Partial Splenic Embolization Versus Splenectomy for the Management of Hypersplenism in Cirrhotic Patients

Partial Splenic Embolization Versus Splenectomy for the Management of Hypersplenism in Cirrhotic Patients

Splenic Arterial Interventions: Anatomy, Indications, Technical Considerations, and Potential Complications

Splenic artery embolization before laparoscopic splenectomy An update

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