Proximal Splenic Artery Embolization In Blunt Splenic Trauma

Zmora, Osnat; Kori, Yitzhak; Samuels, David; Kessler, Ada; Schulman, Carl I.; Klausner, Joseph M.; Soffer, Dror

doi:10.1007/s00068-008-8030-z

Cited by 7 publications

(4 citation statements)

References 22 publications

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“…PSAE works by decreasing the systolic arterial pressure in the spleen, promoting hemostasis and healing within the splenic parenchyma. Blood flow to the spleen is maintained via collaterals, which not only prevents infarction and abscess formation but also preserves splenic immune function (Imbrogno and Ray 2012;Bessoud and Denys 2004;Zmora et al 2009). PSAE may also be performed outside the setting of trauma such as in cases of splenic artery aneurysm/pseudoaneurysm and in post liver transplant splenic artery steal syndrome (Loffroy et al 2008;Saad 2012;Gu et al 2012).…”

Section: Introductionmentioning

confidence: 99%

Review of proximal splenic artery embolization in blunt abdominal trauma

Quencer

Smith

2019

CVIR Endovasc

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The spleen is the most commonly injured organ in blunt abdominal trauma. Unstable patients undergo laparotomy and splenectomy. Stable patients with lower grade injuries are treated conservatively; those stable patients with moderate to severe splenic injuries (grade III-V) benefit from endovascular splenic artery embolization. Two widely used embolization approaches are proximal and distal splenic artery embolization. Proximal splenic artery embolization decreases the perfusion pressure in the spleen but allows for viability of the spleen to be maintained via collateral pathways. Distal embolization can be used in cases of focal injury. In this article we review relevant literature on splenic embolization indication, and technique, comparing and contrasting proximal and distal embolization. Additionally, we review relevant anatomy and discuss collateral perfusion pathways following proximal embolization. Finally, we review potential complications of splenic artery embolization.

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Section: Introductionmentioning

confidence: 99%

Review of proximal splenic artery embolization in blunt abdominal trauma

Quencer

Smith

2019

CVIR Endovasc

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“…Once a pseudoaneurysm is confirmed in a hemodynamically stable patient, angiographic embolization, either proximal or selective, is advocated [18,19]. Angiography is considered to be safe, effective, and, if successful, will avoid laparotomy.…”

Section: Discussionmentioning

confidence: 99%

Doppler ultrasound for the assessment of conservatively treated blunt splenic injuries: a prospective study

Soffer

Wiesel

Schulman

et al. 2010

Eur J Trauma Emerg Surg

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“…Collateral splenic perfusion not only prevents infarction but also helps avoid abscess formation and preserves immune function. 8,9,11 In cases where there is both multifocal splenic injury and focal vascular injury such as a pseudoaneurysm or active extravasation, a combined splenic artery embolization (CSAE) can be performed where both the focal abnormality is selectively embolized followed by a proximal embolization which reduces the arterial pressure to the diffusely fractured spleen.…”

Section: Introductionmentioning

confidence: 99%

Retrospective Evaluation of Splenic Artery Embolization Outcomes in the Management of Blunt Splenic Trauma: A Single Centre Experience at a Large Level 1 Trauma Centre

et al. 2023

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Purpose Retrospective review of splenic artery embolization (SAE) outcomes performed for blunt abdominal trauma. Materials and Methods 11-year retrospective review at a large level-1 Canadian trauma centre. All patients who underwent SAE after blunt trauma were included. Technical success was defined as angiographic occlusion of the target vessel and clinical success was defined as successful non-operative management and splenic salvage on follow-up. Results 138 patients were included of which 68.1% were male. The median age was 47 years (interquartile range (IQR) = 32.5 years). The most common mechanisms of injury were motor vehicle accidents (37.0%), mechanical falls (25.4%), and pedestrians hit by motor vehicles (10.9%). 70.3% of patients had American Association for the Surgery of Trauma (AAST) grade 4 injuries. Patients were treated with proximal SAE (n = 97), distal SAE (n = 23) or combined SAE (n = 18), and 68% were embolized with an Amplatzer plug. No significant differences were observed across all measures of hospitalization (Length of hospital stay: x2(2) = .358, P = .836; intensive care unit (ICU) stay: x2(2) = .390, P = .823; ICU stay post-procedure: x2(2) = 1.048, P = .592). Technical success and splenic salvage were achieved in 100% and 97.8% of patients, respectively. 7 patients (5%) had post-embolization complications and 7 patients (5%) died during hospital admission, but death was secondary to other injuries sustained in the trauma rather than complications related to splenic injury or its management. Conclusion We report that SAE as an adjunct to non-operative management of blunt splenic trauma can be performed safely and effectively with a high rate of clinical success.

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Proximal Splenic Artery Embolization In Blunt Splenic Trauma

Abstract: Proximal embolization of the splenic artery for severe splenic injury is highly successful in cessation of bleeding while preserving splenic architecture. There were minimal complications in this series demonstrated by clinical and Doppler examinations.

Cited by 7 publications

References 22 publications

Review of proximal splenic artery embolization in blunt abdominal trauma

Review of proximal splenic artery embolization in blunt abdominal trauma

Doppler ultrasound for the assessment of conservatively treated blunt splenic injuries: a prospective study

Retrospective Evaluation of Splenic Artery Embolization Outcomes in the Management of Blunt Splenic Trauma: A Single Centre Experience at a Large Level 1 Trauma Centre

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