Devos Johannes, Bonne Lawrence, Cornelissen Sandra, Coudyzer Walter, Laleman Wim, Verslype Chris, Metsemakers Willem-Jan, Maleux Geert
Department of Radiology, University Hospitals Leuven, Leuven, Belgium.
Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium.
J Belg Soc Radiol. 2021 Apr 6;105(1):19. doi: 10.5334/jbsr.2068.
To assess the safety and efficacy of main splenic artery embolization. To assess the potential difference post-embolization of the residual splenic volume in patients embolized for trauma versus those embolized for (pseudo)aneurysms.
A retrospective analysis was performed on a cohort of 65 patients (36 males) who underwent pre- and post-embolization computed tomography. Patients' demographics, pre- and post-interventional medical and radiological data were gathered. Splenic volume calculations were semi-automatically performed via a workstation. Patients with splenic aneurysms or pseudoaneurysms of the main splenic artery (group 1) were compared to those with splenic rupture (group 2) using Wilcoxon rank tests.
The main indications for splenic artery embolization were splenic rupture (n = 22; 34%) and splenic pseudoaneurysm (n = 19; 29%). The technical success rate was n = 63; 97%. The procedure-related complication rate was n = 7; 11%, including abscess formation (n = 5; 8%), re-bleeding (n = 1; 1.5 %) and pseudoaneurysm re-opening (n = 1; 1.5%). The overall 30-day mortality was n = 7; 11%.Median follow-up for groups 1 and 2 was 1163 days (61-3946 days) and 702 days (43-2095 days) respectively. When processable (n = 23), the splenic volume in group 1 (n = 7) was 311 cm and 257 cm (p = 0.1591) before and after embolization respectively, and in group 2 (n = 16) it was 261 cm and 215 cm (p = 0.4688), respectively.
Main splenic artery embolization is efficacious, with low procedure-related complication and 30-day mortality rates. No significant differences in residual post-embolization splenic volume were found between patients treated for splenic rupture versus those treated for splenic arterial (pseudo)aneurysm.
评估脾动脉主干栓塞术的安全性和有效性。评估因创伤接受栓塞治疗的患者与因（假性）动脉瘤接受栓塞治疗的患者栓塞后残余脾体积的潜在差异。
对65例（36例男性）接受栓塞术前和术后计算机断层扫描的患者进行回顾性分析。收集患者的人口统计学资料、介入治疗前后的医学和放射学数据。通过工作站半自动进行脾体积计算。使用Wilcoxon秩和检验将脾动脉瘤或脾动脉主干假性动脉瘤患者（第1组）与脾破裂患者（第2组）进行比较。
脾动脉栓塞的主要适应证为脾破裂（n = 22；34%）和脾假性动脉瘤（n = 19；29%）。技术成功率为n = 63；97%。与手术相关的并发症发生率为n = 7；11%，包括脓肿形成（n = 5；8%）、再次出血（n = 1；1.5%）和假性动脉瘤再通（n = 1；1.5%）。30天总死亡率为n = 7；11%。第1组和第2组的中位随访时间分别为1163天（61 - 3946天）和702天（43 - 2095天）。当可进行分析时（n = 23），第1组（n = 7）栓塞前和栓塞后的脾体积分别为311 cm³和257 cm³（p = 0.1591），第2组（n = 16）分别为261 cm³和215 cm³（p = 0.4688）。
脾动脉主干栓塞术有效，与手术相关的并发症和30天死亡率较低。在因脾破裂接受治疗的患者与因脾动脉（假性）动脉瘤接受治疗的患者之间，未发现栓塞后残余脾体积有显著差异。
