Comparison of outcomes of proximal versus distal and combined splenic artery embolization in the management of blunt splenic injury: a report of 202 cases from a single trauma center

Being Chuan Lin*, Cheng Hsien Wu, Yon Cheong Wong, Huan Wu Chen, Chen Ju Fu, Chen Chih Huang, Chen Te Wu, Yi Kang Ku, Chien Cheng Chen, Ting Wen Sheng, Chun Bi Chang

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

1 Scopus citations

Abstract

BACKGROUND: To compare the outcomes of blunt splenic injuries (BSI) managed with proximal (P) versus distal (D) versus combined (C) splenic artery embolization (SAE).

METHODS: This retrospective study included patients with BSI who demonstrated vascular injuries on angiograms and were managed with SAE between 2001 and 2015. The success rate and major complications (Clavien-Dindo classification ≥ III) were compared between the P, D, and C embolizations.

RESULTS: In total, 202 patients were enrolled (P, n = 64, 31.7%; D, n = 84, 41.6%; C, n = 54, 26.7%). The median injury severity score was 25. The median times from injury to SAE were 8.3, 7.0, and 6.6 h for the P, D, and C embolization, respectively. The overall haemostasis success rates were 92.6%, 93.8%, 88.1%, and 98.1% in the P, D, and C embolizations, respectively, with no significant difference (p = 0.079). Additionally, the outcomes were not significantly different between the different types of vascular injuries on angiograms or the materials used in the location of embolization. Splenic abscess occurred in six patients (P, n = 0; D, n = 5; C, n = 1), although it occurred more commonly in those who underwent D embolization with no significant difference (p = 0.092).

CONCLUSIONS: The success rate and major complications of SAE were not significantly different regardless of the location of embolization. The different types of vascular injuries on angiograms and agents used in different embolization locations also did not affect the outcomes.

Original languageEnglish
Pages (from-to)4689-4697
Number of pages9
JournalSurgical Endoscopy
Volume37
Issue number6
DOIs
StatePublished - 06 2023

Bibliographical note

© 2023. The Author(s).

Keywords

  • Blunt splenic injury
  • Contrast extravasation
  • Location of embolization
  • Pseudoaneurysm
  • Splenic artery embolization
  • Humans
  • Trauma Centers
  • Treatment Outcome
  • Abdominal Injuries
  • Wounds, Nonpenetrating/diagnostic imaging
  • Embolization, Therapeutic/adverse effects
  • Retrospective Studies
  • Splenic Artery
  • Vascular System Injuries
  • Splenic Diseases

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