Corvino Fabio, Giurazza Francesco, Tipaldi Marcello Andrea, Rossi Tommaso, Daviddi Francesco, Perrone Orsola, Ambrosini Ilaria, D'addato Mauro, Villanova Ilaria, Marra Paolo, Carbone Francesco Saverio, Vizzuso Antonio, Smaldone Fernando, Scrofani Anna Rita, Iezzi Roberto, Discalzi Andrea, Calandri Marco, Femia Marco, Valenti Pittino Carlo, Vercelli Ruggero, Falsaperla Daniele, Basile Antonello, Bruno Antonio, Gasperini Chiara, Niola Raffaella
Interventional Radiology Department, AORN "A. Cardarelli", 80131 Naples, Italy.
Department of Surgical and Medical Sciences and Translational Medicine, Sapienza-University of Rome, 00189 Rome, Italy.
J Pers Med. 2025 Sep 3;15(9):420. doi: 10.3390/jpm15090420.
Splenic artery embolization (SAE) has emerged as a key adjunct to non-operative management (NOM) in hemodynamically stable patients with blunt splenic trauma, yet variability in its application persists across centers. The aim was to evaluate real-life clinical practices, techniques, and outcomes of SAE in blunt splenic trauma across multiple Italian trauma centers. This retrospective multicenter study analyzed data from 281 patients undergoing emergency SAE for blunt splenic trauma between January 2019 and December 2021. Demographics, imaging findings, embolization techniques, complications, and outcomes were collected and analyzed. Multivariate logistic regression was used to assess predictors of splenectomy. The technical success rate was 100%, with a 9.6% rate of post-embolization splenectomy and a complication rate of 24.9% (including 5.7% splenic infarction and 3.2% rebleeding). Embolization was performed proximally (46.6%), distally (28.8%), or with a combined approach (24.6%). No significant correlation was found between embolization technique and splenectomy rate. Patients with AAST grade III injuries benefited from SAE with high technical success and low failure rates. Notably, 14.2% of patients underwent angiography despite negative CT, with a splenectomy rate of 10% in this subgroup. Multivariate analysis identified no independent predictors of splenectomy. SAE is a reliable and effective tool in the management of blunt splenic trauma, achieving high splenic salvage rates even in selected grade III injuries and CT-negative patients. In an era of precision medicine, interventional radiology should be regarded as a distinct and specific treatment modality, comparable to surgery, rather than being merely included within non-operative management (NOM).
脾动脉栓塞术（SAE）已成为血流动力学稳定的钝性脾外伤患者非手术治疗（NOM）的关键辅助手段，但各中心在其应用方面仍存在差异。本研究旨在评估意大利多个创伤中心在钝性脾外伤中SAE的实际临床实践、技术及结果。这项回顾性多中心研究分析了2019年1月至2021年12月期间281例因钝性脾外伤接受急诊SAE治疗的患者数据。收集并分析了人口统计学资料、影像学表现、栓塞技术、并发症及结果。采用多因素逻辑回归评估脾切除的预测因素。技术成功率为100%，栓塞后脾切除率为9.6%，并发症发生率为24.9%（包括5.7%的脾梗死和3.2%的再出血）。栓塞在近端进行（46.6%）、远端进行（28.8%）或采用联合方法（24.6%）。未发现栓塞技术与脾切除率之间存在显著相关性。美国创伤外科学会（AAST）III级损伤患者从SAE中获益，技术成功率高且失败率低。值得注意的是，14.2%的患者尽管CT检查结果为阴性仍接受了血管造影，该亚组的脾切除率为10%。多因素分析未发现脾切除的独立预测因素。SAE是钝性脾外伤治疗中一种可靠且有效的工具，即使在选定的III级损伤和CT检查阴性的患者中也能实现较高的脾脏保留率。在精准医学时代，介入放射学应被视为一种独特且特定的治疗方式，与手术相当，而不仅仅被纳入非手术治疗（NOM）之中。
