[Usefulness of partial splenic embolization (PSE) in hepatocellular carcinomas showing a risk of gastrointestinal bleeding after transcatheter arterial embolization (TAE)].

We have examined 103 patients with a hepatocellular carcinoma (HCC) who were treated by transcatheter arterial embolization (TAE) with a partial splenic embolization (PSE) (n = 5) or without a PSE (n = 98). It was found that gastrointestinal (GI) bleeding after TAE occurred in 10 (10.2%) out of the 98 TAE patients and within 10 days after the TAE. In these GI bleeding after TAE patients, the platelet counts were significantly low and marked splenomegaly was seen. It also was found that there was a risk of GI bleeding after TAE in cases showing thrombocytopenia (less than 50,000/microliters) and marked splenomegaly with a splenic index of more than 50. In 5 patients with a high risk of GI bleeding, for whom a PSE was performed, the platelet counts were markedly increased even four weeks after the TAE. The survival rate of TAE patients given a PSE was significantly higher than in TAE patients manifesting a risk of GI bleeding. From these results, it would seem that TAE patients given a PSE is the better therapy for HCC patients manifesting a risk of GI bleeding.