Trends in Blunt Splenic Injury Management: The Rise of Splenic Artery Embolization

2021 ◽  
Vol 265 ◽  
pp. 86-94
Author(s):  
D'Arcy Marsh ◽  
Marilyn Day ◽  
Amit Gupta ◽  
Emily C. Huang ◽  
Wei Hou ◽  
...  
Keyword(s):  
Splenic Artery ◽  
Splenic Injury ◽  
Artery Embolization ◽  
Splenic Artery Embolization ◽  
Blunt Splenic Injury ◽  
Injury Management

scholarly journals Impact of Splenic Artery Embolization on the Success Rate of Nonoperative Management for Blunt Splenic Injury

2011 ◽  
Vol 35 (1) ◽  
pp. 76-81 ◽  
Author(s):  
C. H. van der Vlies ◽  
J. Hoekstra ◽  
K. J. Ponsen ◽  
J. A. Reekers ◽  
O. M. van Delden ◽  
...  
Keyword(s):  
Success Rate ◽  
Splenic Artery ◽  
Splenic Injury ◽  
Nonoperative Management ◽  
Artery Embolization ◽  
Splenic Artery Embolization ◽  
Blunt Splenic Injury

scholarly journals Predictors of splenic artery embolization as an adjunct to non-operative management of stable blunt splenic injury: a multi-institutional study

2019 ◽  
Vol 4 (1) ◽  
pp. e000323 ◽  
Author(s):  
Kristin Salottolo ◽  
Matthew M Carrick ◽  
Robert M Madayag ◽  
James Yon ◽  
Allen Tanner ◽  
...  
Keyword(s):  
Splenic Artery ◽  
Splenic Injury ◽  
Motor Vehicle ◽  
Multivariate Logistic Regression Analysis ◽  
Operative Management ◽  
Artery Embolization ◽  
Splenic Artery Embolization ◽  
Radiographic Findings ◽  
Blunt Splenic Injury ◽  
Non Operative Management

BackgroundWe sought to identify predictors of splenic artery embolization (SAE) over observation for hemodynamically stable patients with blunt splenic injury (BSI), by Organ Injury Scale (OIS) grade.MethodsThis was a multi-institutional retrospective study of all adults (≥18) with BSI who were initially managed non-operatively between 2014 and 2016. Multivariate logistic regression analysis was used to identify predictors of SAE by OIS grade. Covariates included radiographic characteristics (presence/quantity of hemoperitoneum, blush, vascular injury), demographics (age, sex, cause), Injury Severity Score, vital signs, and hemoglobin values. We also examined outcomes of death, length of stay (LOS), intensive care unit (ICU) admission, blood products, and failed non-operative management (NOM).ResultsAmong 422 patients with stable BSI, 93 (22%) had SAE and 329 (78%) were observed. The rate of SAE increased by grade (p<0.001). In grade I and II BSI, 7% had SAE; significant predictors of SAE were blush (OR: 5.9, p=0.02), moderate or large hemoperitoneum (OR: 3.0, p=0.01), and male sex (OR: 6.3, p=0.05). In grade III BSI, 26% had SAE; significant predictors included moderate or large hemoperitoneum (OR: 3.9, p=0.04), motor vehicle crash (OR: 6.1, p=0.005), and age (OR=1.4, 40% with each decade increase in age, p=0.02). The rate of SAE was 52% for grade IV and 85% for grade V BSI; there were no independent predictors of SAE in either grade. Clinical outcomes were comparable by NOM strategy and grade, except longer LOS with SAE in grades I–III (p<0.05) and longer ICU LOS with SAE in grades I–IV (p<0.05). Only 5 (1.2%) patients failed NOM (4 observation, 1 SAE).ConclusionThese results strongly support SAE consideration for patients with stable grade IV and V BSI even if there are no other high-risk clinical or radiographic findings. For grades I–III, the identified predictors may help refine consideration for SAE.Level of evidenceLevel III, retrospective epidemiological study.

Proximal Splenic Artery Embolization for Blunt Splenic Injury: Clinical, Immunologic, and Ultrasound-Doppler Follow-Up

2007 ◽  
Vol 62 (6) ◽  
pp. 1481-1486 ◽  
Author(s):  
Bertrand Bessoud ◽  
Michel A. Duchosal ◽  
Claire-Anne Siegrist ◽  
Susanna Schlegel ◽  
Francesco Doenz ◽  
...  
Keyword(s):  
Splenic Artery ◽  
Splenic Injury ◽  
Artery Embolization ◽  
Splenic Artery Embolization ◽  
Blunt Splenic Injury ◽  
Ultrasound Doppler

scholarly journals Blunt Splenic Injury: Efficacy of Superselective Splenic Artery Embolization

2014 ◽  
Vol 3 (2) ◽  
pp. 37-48
Author(s):  
CP Chou ◽  
YH Kim ◽  
S Tresoldi ◽  
EI Tikh ◽  
S Baker ◽  
...  
Keyword(s):  
Splenic Artery ◽  
Splenic Injury ◽  
Pancreatic Injury ◽  
Organ Injury ◽  
Splenic Trauma ◽  
Artery Embolization ◽  
Safe Alternative ◽  
Splenic Artery Embolization ◽  
Blunt Splenic Injury ◽  
Catheter Technique

Objective: To evaluate the efficacy of superselective splenic artery embolization (SAE) using a coaxial catheter technique in patients with blunt splenic injury. Patient Selection and Methods: We retrospectively reviewed cases of 24 consecutive patients undergoing splenic angiography for blunt splenic injury at a Level 1 trauma center. After angiographic confirmation of splenic injury, superselective SAE was performed using gelfoam pledgets (n=15), with or without coils, and liquid embolic materials (n=9). All procedures were performed through a microcatheter advanced coaxially through a selective angiographic catheter. Severity of splenic injury was graded using CT imaging. The angiographic findings were retrospectively divided into four groups. Outcome measures included technical success, complications and recurrence of symptoms requiring additional intervention or surgery despite embolization. Results: All cases were technically successful, with immediate occlusion of targeted vessels after embolization. One patient underwent distal pancreatectomy- splenectomy 3 days after splenic embolization due to symptoms related to distal pancreatic injury, unrelated to the angiographic intervention. A second embolization was performed 1-3 days after initial embolization in 4 patients with clinical suspicion of re-bleeding. One of these four patients underwent splenectomy 3 days after the second embolization, during exploration for associated bowel and diaphragmatic injury. A second patient underwent splenectomy 1 day after a second embolization due to need for continued transfusions. The splenic salvage rate was not significantly related to CT grade of splenic injury (p=1.0) or angiographic classification (p=0.8). Conclusion: Superselective SAE can be performed as a safe alternative to splenectomy in patients with blunt splenic trauma, particularly when there is no additional major organ injury. DOI: http://dx.doi.org/10.3126/njr.v3i2.9606 Nepalese Journal of Radiology Vol.3(2)July-Dec, 2013: 37-48

Use of Splenic Artery Embolization as an Adjunct to Nonsurgical Management of Blunt Splenic Injury

2004 ◽  
Vol 56 (4) ◽  
pp. 768-773 ◽  
Author(s):  
Po Ping Liu ◽  
Wei Che Lee ◽  
Yu Fan Cheng ◽  
Pei Min Hsieh ◽  
Yu Min Hsieh ◽  
...  
Keyword(s):  
Splenic Artery ◽  
Splenic Injury ◽  
Artery Embolization ◽  
Splenic Artery Embolization ◽  
Blunt Splenic Injury ◽  
Nonsurgical Management

scholarly journals Blunt splenic injury: Outcomes of proximal versus distal and combined splenic artery embolization

2014 ◽  
Vol 95 (9) ◽  
pp. 825-831 ◽  
Author(s):  
J. Frandon ◽  
M. Rodière ◽  
C. Arvieux ◽  
M. Michoud ◽  
A. Vendrell ◽  
...  
Keyword(s):  
Splenic Artery ◽  
Splenic Injury ◽  
Artery Embolization ◽  
Splenic Artery Embolization ◽  
Blunt Splenic Injury ◽  
Injury Outcomes
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