Department of Radiology, Section of Interventional Radiology, Northwestern University, Chicago, IL, USA.
Department of Radiology, Section of Interventional Radiology, Northwestern University, Chicago, IL, USA.
Clin Imaging. 2021 Dec;80:160-166. doi: 10.1016/j.clinimag.2021.07.007. Epub 2021 Jul 26.
Splenic artery pseudoaneurysms (PSA) are relatively rare but associated with high mortality/morbidity when presenting acutely. Embolization has emerged as the treatment of choice. We aim to evaluate the outcomes of embolization for the treatment of splenic artery PSAs.
From 2007 to 2019, all patients that underwent embolization for splenic artery PSAs were included in this IRB-approved review. Evaluated outcomes included complications, morbidity/mortality rates, and 30-day white blood cell count. Student t-tests were performed to compare laboratory values before and after embolization. 5-year survival rates were estimated using Kaplan Meier methodology.
A retrospective analysis of 24 patients (14 males, mean age 51 ± 19 years) who underwent splenic artery PSA embolization was performed. Fifteen PSA embolizations were performed in an emergent setting. There was technical success in 23/24 patients. Etiologies included trauma (10), pancreatitis (9), post-surgical (3), and malignancy (2). Post-embolization patients had a mean length of stay of 19 days and within 30 days, 9 patients developed leukocytosis (median of 14,800/μl). The 5-year survival rate of these patients was 89% [95% CI 75% - 100%]. Post-procedure, 4 patients developed grade 2 complications. Grade 3 complications were observed in 5 patients. One (4.2%) splenic abscess was identified. Of the 19 patients with follow-up imaging, 14 patients had splenic infarcts (5 infarcts were >50% of splenic volume).
Splenic artery PSAs are encountered in the emergent setting and are most frequently secondary to trauma or pancreatitis. Embolization can be life-saving in these critically ill patients.
脾动脉假性动脉瘤（PSA）相对少见，但在急性发作时死亡率/发病率较高。栓塞已成为首选治疗方法。我们旨在评估栓塞治疗脾动脉 PSA 的结果。
在 2007 年至 2019 年期间，所有接受脾动脉 PSA 栓塞治疗的患者均纳入这项经机构审查委员会批准的回顾性研究。评估的结果包括并发症、发病率/死亡率以及 30 天白细胞计数。采用学生 t 检验比较栓塞前后的实验室值。使用 Kaplan-Meier 方法估计 5 年生存率。
对 24 例（男性 14 例，平均年龄 51±19 岁）接受脾动脉 PSA 栓塞治疗的患者进行了回顾性分析。15 例 PSA 栓塞在紧急情况下进行。23/24 例患者技术上获得成功。病因包括创伤（10 例）、胰腺炎（9 例）、手术后（3 例）和恶性肿瘤（2 例）。栓塞后患者的平均住院时间为 19 天，30 天内 9 例出现白细胞增多（中位数为 14800/μl）。这些患者的 5 年生存率为 89%[95%CI 75% - 100%]。术后 4 例患者出现 2 级并发症，5 例患者出现 3 级并发症。发现 1 例（4.2%）脾脓肿。在有随访影像学的 19 例患者中，14 例患者有脾梗死（5 例梗死>50%的脾体积）。
脾动脉 PSA 常见于紧急情况下，最常见于创伤或胰腺炎。在这些危重患者中，栓塞可以救命。
Zotero 插件