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Splenic Embolization (splenic + embolization)

Distribution by Scientific Domains
Medical Sciences100%

Kinds of Splenic Embolization

  • partial splenic embolization
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    Selected Abstracts

    Partial splenic embolization in children with hereditary spherocytosis

    EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 1 2008
    Barbara Pratl
    Abstract Objectives:, Although total splenectomy is able to reduce clinical symptoms in patients with hereditary spherocytosis (HS), splenectomized patients are at risk to develop overwhelming bacterial infections and, to a lesser extent, thromboembolic complications. In contrast, partial splenectomy or partial splenic embolization (PSE) may also decrease the rate of hemolytic complications while maintaining residual splenic function. The aim of this study was to investigate the benefit of PSE in children with moderate to severe HS. Patients and methods:, We performed PSE via retrograde transfemoral access in eight children (four female, four male) with moderate to severe HS at a median age of 8 yr. HS-related complications before PSE included gallstones in six and aplastic crises in four children. One patient was transfusion-dependent. Results:, No acute side effects were seen during or after PSE. Median hemoglobin increased significantly from levels between 7.5 g/dL and 11.65 g/dL before PSE to levels between 8.4 g/dL and 13.35 g/dL after PSE (P = 0.012). Median splenic sizes before PSE ranged from 9.7 cm/m2 to 19.0 cm/m2 and significantly decreased to values between 4.4 cm/m2 and 15.65 cm/m2 during follow-up (P = 0.012). Conclusions:, PSE appears to be a safe, effective and feasible treatment option for the management of children with moderate to severe HS. [source]

    Predictive factors for platelet increase after partial splenic embolization in liver cirrhosis patients

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 10 2007
    Hiromitsu Hayashi
    Abstract Background and Aim:, Partial splenic embolization (PSE) is often performed for improving thrombocytopenia in cirrhotic patients. We investigated the largely unclear predictive factors for platelet increase at both 1 month and 1 year after PSE. Methods:, Aimed at increasing the platelet count, PSE was performed in 42 cirrhotic patients with thrombocytopenia (platelets < 80 × 104/mL) caused by hypersplenism. The clinical data were analyzed to clarify the predictive factors for platelet increase at 1 month (n = 42) and 1 year (n = 38) after PSE. Results:, The mean splenic infarction ratio was 76.7% ± 11.2%. The platelet count increased to 259% ± 112% and 228% ± 75% of the pretreatment values at 1 month and at 1 year after PSE, respectively. Stepwise multiple linear regression analysis showed that the infarcted splenic volume had a positive independent association with the increase in platelet count at both 1 month (P = 0.00004) and 1 year (P = 0.005) after PSE (increase in platelet count (×104/mL): at 1 month = 0.752 + 0.018 × infarcted splenic volume (mL), R2 = 0.344; at 1 year = 2.19 + 0.01 × infarcted splenic volume (mL), R2 = 0.203). Receiver operating characteristic analysis yielded a cut-off value of 388 mL of infarcted splenic volume for achieving an increase of 5.0,8.0 × 104/mL in platelet count at 1 year. Conclusions:, PSE can reduce the platelet pool and induce an increase in platelet count. This increase is greatly dependent on the infarcted splenic volume. [source]

    Protracted pain following partial splenic embolization in an adolescent female with hypersplenism

    PEDIATRIC ANESTHESIA, Issue 11 2005
    ARJUNAN GANESH MD
    Summary A 17-year-old female with massive splenomegaly underwent partial splenic embolization (PSE) for hypersplenism. The postoperative course was characterized by recurrent painful splenic infarctions requiring hydromorphone PCA for an extended period resulting in an unanticipated, prolonged hospital stay. Massive splenomegaly treated with PSE may require an extended hospital stay to achieve pain control. Such patients may subsequently require transition to enteral opioids and weaning. [source]

    Partial splenic embolization and peg-IFN plus RBV in liver transplanted patients with hepatitis C recurrence: safety, efficacy and long-term outcome

    CLINICAL TRANSPLANTATION, Issue 3 2010
    Rafael Bárcena
    Bárcena R, Moreno A, Foruny JR, Blázquez J, Graus J, Riesco JM, Blesa C, García-Hoz F, Sánchez J, Gil-Grande L, Nuño J, Fortún J, Rodriguez-Sagrado MA, Moreno A. Partial splenic embolization and peg-IFN plus RBV in liver transplanted patients with hepatitis C recurrence: safety, efficacy and long-term outcome. Clin Transplant 2010: 24: 366,374. © 2009 John Wiley & Sons A/S. Abstract:,Background:, There is limited information on the long-term outcome in liver transplant (LT) subjects undergoing partial splenic embolization (PSE) prior to full dose pegylated interferon/ribavirin (peg-IFN/RBV). Methods:, Retrospective review of eight LT subjects after PSE and antiviral therapy. Results:, Baseline platelets and neutrophils were <50 000 cells/mL and <1000 cells/mL in 75% and 50%. Mean splenic infarction volume was 85 ± 13%. PSE produced major complications in three (37.5%): recurrent sterile netrophilic ascites and renal insufficiency (n = 2), and splenic abscess (n = 1). Full-dose peg-IFN/RBV was started in seven (87.5%), with two early withdrawals (28.6%) despite early virological response (toxicity and infection); both subjects died. Anemia led to RBV dose-adjustment in six (86%), with human recombinant erythropoietin (EPO) use in four (57%). No peg-IFN adjustments or granulocyte-colonies stimulating factor were needed. Two patients reached sustained virological response (SVR) (28.6%). Two non-responders maintained prolonged therapy with biochemical/histological improvement. After a median follow-up of 151 wk, we observed significant improvements in hematological parameters, aspartate aminotransferase, alanine aminotransferase, international normalized ratio, and prothrombin activity. Conclusions:, Extensive PSE after LT produced significant morbidity (37.5%). Peg-IFN/RBV was completed in five out of seven (71%), with SVR in two (28.6%). RBV adjustement due to anemia was high despite EPO use. Only patients able to complete or maintain antiviral therapy survived, with long-term significant benefits in hematological parameters and liver function tests. [source]