Temporal Assessment of Splenic Function in Patients Who Have Undergone Percutaneous Image-Guided Splenic Artery Embolization in the Setting of Trauma

Pirasteh, Ali; Snyder, Laura; Lin, Roger; Rosenblum, David I.; Reed, Steven; Sattar, Abdus; Passalacqua, Matthew; Prologo, J. David

doi:10.1016/j.jvir.2011.09.009

Cited by 22 publications

(14 citation statements)

References 18 publications

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“…After review of titles and abstracts, 44 studies were preliminarily identified for further evaluation. Of the 44 studies, 12 were excluded without follow-up [1, 12, 15, 17, 20–23, 37–40], and 9 studies were excluded because of the lack of detailed data about SAE techniques [19, 29, 31, 41–46]. Finally, 23 relevant studies [7, 10, 11, 16, 25–28, 30, 32, 47–59] were included as 1st study set.…”

Section: Resultsmentioning

confidence: 99%

“…It is beneficial for clot formation rather than stop the hemorrhage directly [4, 23, 40, 47, 48], and it is advantageous to control multiple splenic injuries [23, 28]. Meanwhile, the rich network of collateral circulation from the left gastric, gastroepiploic arteries, pancreatic and omental branches enters the spleen to minimize the risk of infarction and preserve the function [12, 15, 20, 23, 25, 38, 39, 47, 48, 58]. In contrast, distal subselection embolization may not be feasible in these situations.…”

Section: Discussionmentioning

confidence: 99%

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The impacts of different embolization techniques on splenic artery embolization for blunt splenic injury: a systematic review and meta-analysis

et al. 2017

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BackgroundSplenic artery embolization (SAE) has been an effective adjunct to the Non-operative management (NOM) for blunt splenic injury (BSI). However, the optimal embolization techniques are still inconclusive. To further understand the roles of different embolization locations and embolic materials in SAE, we conducted this system review and meta-analyses.MethodsClinical studies related to SAE for adult patients were researched in electronic databases, included PubMed, Embase, ScienceDirect and Google Scholar Search (between October 1991 and March 2013), and relevant information was extracted. To eliminate the heterogeneity, a sensitivity analysis was conducted on two reduced study sets. Then, the pooled outcomes were compared and the quality assessments were performed using Newcastle-Ottawa Scale (NOS). The SAE success rate, incidences of life-threatening complications of different embolization techniques were compared by χ 2 test in 1st study set. Associations between different embolization techniques and clinical outcomes were evaluated by fixed-effects model in 2nd study set.ResultsTwenty-three studies were included in 1st study set. And then, 13 of them were excluded, because lack of the necessary details of SAE. The remaining 10 studies comprised 2nd study set, and quality assessments were performed using NOS. In 1st set, the primary success rate is 90.1% and the incidence of life-threatening complications is 20.4%, though the cases which required surgical intervention are very few (6.4%). For different embolization locations, there was no obvious association between primary success rate and embolization location in both 1st and 2nd study sets (P > 0.05). But in 2nd study set, it indicated that proximal embolization reduced severe complications and complications needed surgical management. As for the embolic materials, the success rate between coil and gelfoam is not significant. However, coil is associated with a lower risk of life-threatening complications, as well as less complications requiring surgical management.ConclusionsDifferent embolization techniques affect the clinical outcomes of SAE. The proximal embolization is the best option due to the less life-threatening complications. For commonly embolic material, coil is superior to gelfoam for fewer severe complications and less further surgery management.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The impacts of different embolization techniques on splenic artery embolization for blunt splenic injury: a systematic review and meta-analysis

et al. 2017

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“…It has been demonstrated that immune function after splenic artery embolization is similar to patients who have not been embolized and superior to patients who have undergone splenectomy. 5,7,15,16 During the decade examined in this study, extravasation on initial CT was cited as the indication to choose splenic embolization, but it has been demonstrated that even when children have contrast extravasation from the spleen, they are unlikely to require operative management. 17 The finding in this study that three of eight patients who failed nonoperative management had active extravasation offers some credence to the use of this criterion for embolization.…”

Section: Discussionmentioning

confidence: 99%

Embolization for pediatric blunt splenic injury is an alternative to splenectomy when observation fails

Gross

Woll

Hanson

et al. 2013

Journal of Trauma and Acute Care Surgery

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“…Phagocytic function of the spleen in patients who have undergone splenic angioembolisation has been measured by analysis of blood for the presence of Howell-Jolly bodies, and very few patients seem to show evidence of hyposplenism. [60][61][62] How should patients who have had non-operative management of splenic injury be followed up?…”

Section: What Is the Role Of Vaccination In Patients With Splenic Injmentioning

confidence: 99%

Modern management of splenic trauma

Hildebrand

Ben-Sassi

Ross

et al. 2014

BMJ

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Temporal Assessment of Splenic Function in Patients Who Have Undergone Percutaneous Image-Guided Splenic Artery Embolization in the Setting of Trauma

Cited by 22 publications

References 18 publications

The impacts of different embolization techniques on splenic artery embolization for blunt splenic injury: a systematic review and meta-analysis

The impacts of different embolization techniques on splenic artery embolization for blunt splenic injury: a systematic review and meta-analysis

Embolization for pediatric blunt splenic injury is an alternative to splenectomy when observation fails

Modern management of splenic trauma

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