TY - JOUR
T1 - Comparison of outcomes of proximal versus distal and combined splenic artery embolization in the management of blunt splenic injury
T2 - a report of 202 cases from a single trauma center
AU - Lin, Being Chuan
AU - Wu, Cheng Hsien
AU - Wong, Yon Cheong
AU - Chen, Huan Wu
AU - Fu, Chen Ju
AU - Huang, Chen Chih
AU - Wu, Chen Te
AU - Ku, Yi Kang
AU - Chen, Chien Cheng
AU - Sheng, Ting Wen
AU - Chang, Chun Bi
N1 - © 2023. The Author(s).
PY - 2023/6
Y1 - 2023/6
N2 - 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.
AB - 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.
KW - Blunt splenic injury
KW - Contrast extravasation
KW - Location of embolization
KW - Pseudoaneurysm
KW - Splenic artery embolization
KW - Humans
KW - Trauma Centers
KW - Treatment Outcome
KW - Abdominal Injuries
KW - Wounds, Nonpenetrating/diagnostic imaging
KW - Embolization, Therapeutic/adverse effects
KW - Retrospective Studies
KW - Splenic Artery
KW - Vascular System Injuries
KW - Splenic Diseases
UR - http://www.scopus.com/inward/record.url?scp=85149384536&partnerID=8YFLogxK
U2 - 10.1007/s00464-023-09960-5
DO - 10.1007/s00464-023-09960-5
M3 - 文章
C2 - 36890415
AN - SCOPUS:85149384536
SN - 0930-2794
VL - 37
SP - 4689
EP - 4697
JO - Surgical Endoscopy
JF - Surgical Endoscopy
IS - 6
ER -