Two-step complete splenic artery embolization for the management of symptomatic sinistral portal hypertension

2021 ◽  
pp. 1-7
Author(s):  
Jiacheng Liu ◽  
Jie Meng ◽  
Ming Yang ◽  
Chen Zhou ◽  
Chongtu Yang ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Splenic Artery ◽  
Artery Embolization ◽  
Splenic Artery Embolization ◽  
Sinistral Portal Hypertension

scholarly journals Role of Splenic Artery Embolization in Gastric Variceal Hemorrhage due to Sinistral Portal Hypertension

2018 ◽  
Vol 03 (01) ◽  
pp. 027-036
Author(s):  
Bibin Sebastian ◽  
Soumil Singhal ◽  
Rohit Madhurkar ◽  
Arun Alex ◽  
M. Uthappa
Keyword(s):  
Portal Hypertension ◽  
Splenic Artery ◽  
Venous Pressure ◽  
Splenic Vein ◽  
Venous Hypertension ◽  
Variceal Hemorrhage ◽  
Artery Embolization ◽  
Splenic Artery Embolization ◽  
Sinistral Portal Hypertension ◽  
Gastric Variceal Hemorrhage

AbstractSinistral or left-sided portal hypertension is a localized form of portal hypertension usually due to isolated obstruction of splenic vein. Most commonly, it is secondary to pancreatitis. Rarely this can present as life-threatening gastric variceal bleeding. In such patients, splenectomy is traditionally considered as the treatment of choice to relieve venous hypertension. Unfortunately, a surgical operation may not be safe in most of the patients because of the unfavorable operative field. Splenic artery embolization (SAE) is an effective method, theoretically akin to splenectomy, blocking the direct arterial inflow to the spleen and thereby reducing the outflow venous pressure. The authors demonstrate a case of a 58-year-old man who presented with severe gastric variceal hemorrhage due to sinistral portal hypertension (SPH) secondary to an episode of pancreatitis, which he had 1 month back. He was successfully managed by SAE and remains symptom-free. The authors bring to the fore the potential curability of gastric variceal hemorrhage secondary to SPH using SAE, which is a safe and effective interventional radiologic procedure.

scholarly journals Severe Complications After Splenic Artery Embolization for Portal Hypertension Due to Hepatic Cirrhosis

2020 ◽  
Vol Volume 13 ◽  
pp. 135-140 ◽  
Author(s):  
Lei Zhang ◽  
Zhan-Guo Zhang ◽  
Xin Long ◽  
Fei-Long Liu ◽  
Wan-Guang Zhang
Keyword(s):  
Portal Hypertension ◽  
Splenic Artery ◽  
Hepatic Cirrhosis ◽  
Artery Embolization ◽  
Splenic Artery Embolization

scholarly journals Splenic Embolization for Recalcitrant Post-TIPS Encephalopathy

2018 ◽  
Vol 1 (3) ◽  
pp. 122-125
Author(s):  
Travedi Premal ◽  
◽  
Kriss Michael ◽  
Biggins Scott ◽  
Johnson Thor ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Splenic Artery ◽  
Clinical Problem ◽  
Artery Embolization ◽  
Splenic Artery Embolization ◽  
Splenic Volume ◽  
Portosystemic Shunts ◽  
Splenic Embolization ◽  
Potential Alternative

Encephalopathy in the setting of transjugular portosystemic shunts (TIPS) is a difficult clinical problem. Shunt reduction often improves encephalopathy but increases the risk of portal hypertension related complications. In this case we describe the use of partial splenic artery embolization in a 60-year-old female who presented with both TIPS dysfunction and refractory encephalopathy. Prior to treatment the patient had an elevated TIPS gradiant, visible varices by endoscopy, and encephalopathy that was severe and refractory enough to be considered for hospice. Following 60% splenic volume embolization, encephalopathy resolved, varices decompressed, and patient was able to be discharged home. This demonstrates that splenic embolization may be considered as a potential alternative to TIPS reduction in the setting of TIPS dysfunction and encephalopathy.

scholarly journals Splenic artery embolization with detachable balloons for hypersplenism

2018 ◽  
Vol 46 (10) ◽  
pp. 4111-4119 ◽  
Author(s):  
Xiaoxi Pang ◽  
Tengyu Li ◽  
Cheng’en Wang
Keyword(s):  
Computed Tomography ◽  
Portal Hypertension ◽  
Splenic Artery ◽  
Coagulation Factors ◽  
Blood Parameters ◽  
Therapeutic Modality ◽  
Artery Embolization ◽  
Abdominal Ultrasonography ◽  
Splenic Artery Embolization ◽  
Splenic Parenchyma

Objective This study was performed to investigate the efficacy of proximal splenic artery embolization using detachable balloons for patients with hypersplenism and portal hypertension. Methods Twelve patients diagnosed with hypersplenism with thrombocytopenia or leukocytopenia caused by portal hypertension were treated by proximal splenic artery embolization with detachable balloons and metallic fibered coils. All patients were followed for up to 6 months. Blood parameters, coagulation factors, and liver function indicators were measured. Enhanced computed tomography and abdominal ultrasonography examinations were also performed in advance to confirm the infarction area and evaluate the changes in spleen size. Results Postoperative angiography demonstrated complete embolization of the proximal splenic artery in all 12 patients. Thrombocyte and leukocyte counts rose significantly in all patients in 2 weeks and stayed significantly higher than those before embolization throughout the 6-month follow-up. The total bilirubin concentration and prothrombin activity recovered significantly and returned to normal levels 6 months later. Computed tomography revealed partial infarction and liquefaction of the splenic parenchyma in nine patients. Conclusions Proximal splenic artery embolization using detachable balloons could be considered a safe and effective therapeutic modality in alleviating hypersplenism secondary to portal hypertension.

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