Pros and cons of splenic artery embolization after mechanical splenic injury - comparison of methods
DOI:
https://doi.org/10.12775/JEHS.2023.13.01.040Keywords
blunt trauma to the spleen, embolization, mechmechanical injury of the spleen, splenic artery embolization complicationsAbstract
Introduction: Mechanical damage of the spleen is a serious therapeutic problem often leading to the death of
the patient. The constant development of therapeutic methods makes it possible to reduce the percentage of
severe conditions after damage to this organ. Great hopes are placed on minimal-invasive treatments and
procedures such as embolization.
Aim of the study: Compare available research as well as publications and identify advantages and
disadvantages of splenic artery embolization in relation to other methods.
Methods and materials: We reviewed the literature available on PubMed and Google Scholar using the words
"splenic artery embolization," "blunt splenic trauma," "splenectomy," "splenectomy after trauma," "nonoperative
treatment of blunt splenic trauma".
Results: Embolization of the splenic artery combines relatively low invasiveness with very high therapeutic
options that were once reserved exclusively for surgical management. Embolization significantly reduces
mortality in the worst prognosis patients and is recommended during non-operative management.
Conclusion: Embolization procedure is found to be superior to other types of management on almost every
level. In addition, this procedure is an ideal follow-up to non-operative management. However, embolization as
well as any other procedure carried out in the spleen should be considered individually and on many levels
because of the important functions performed by this organ.
Key words: Blunt trauma to the spleen, embolization, mechanical injury of the spleen, splenic artery
embolization complications;
References
E Girard 1, J Abba 1, N Cristiano 1, M Siebert 1, S Barbois 1, C Létoublon 1, C Arvieux 2. Management of
splenic and pancreatic trauma. J Visc Surg. 2016 Aug;153(4 Suppl):45-60. doi: 10.1016/j.jviscsurg.2016.04.005.
Epub 2016 Jul 9. PMID: 27402320
Chaitanya Ahuja 1, Khashayar Farsad 2, Meghna Chadha . An Overview of Splenic Embolization. AJR Am
J Roentgenol. 2015 Oct;205(4):720-5. doi: 10.2214/AJR.15.14637. PMID: 26397320
E E Moore 1, S R Shackford, H L Pachter, J W McAninch, B D Browner, H R Champion, L M Flint, T A
Gennarelli, M A Malangoni, M L Ramenofsky, et al. Organ injury scaling: spleen, liver, and kidney. J Trauma.
Dec;29(12):1664-6. PMID: 2593197
Elroy P Weledji 1. Benefits and risks of splenectomy. Int J Surg. 2014;12(2):113-9. doi:
1016/j.ijsu.2013.11.017. Epub 2013 Dec 3. PMID: 24316283
James M Haan 1, Grant V Bochicchio, N Kramer, Thomas M Scalea. Nonoperative management of blunt
splenic injury: a 5-year experience. J Trauma. 2005 Mar;58(3):492-8. doi: 10.1097/01.ta.0000154575.49388.74.
PMID: 15761342
A Zarzavadjian Le Bian 1, M Cesaretti 2, R Costi 3, N El Arbi 2, C Smadja 4, A Valverde 5. Laparoscopic
partial splenectomy with selective pedicular approach (with video). J Visc Surg. 2017 Feb;154(1):63-64. doi:
1016/j.jviscsurg.2016.11.001. Epub 2017 Jan 31. PMID: 28159500
José Donizeti Meira Júnior 1, Carlos Augusto Metidieri Menegozzo 1, Marcelo Cristiano Rocha 1, Edivaldo
Massazo Utiyama 1. Non-operative management of blunt splenic trauma: evolution, results and controversies.
Rev Col Bras Cir. 2021 May 7;48:e20202777. doi: 10.1590/0100-6991e-20202777. eCollection 2021. PMID:
Isaac Chun-Jen Chen 1, Shang-Chiung Wang, Hsin-Chin Shih, Chien-Ying Wang, Chen-Chi Liu, Yi-Szu
Wen, Mu-Shun Huang. Spleen artery embolization increases the success of nonoperative management following
blunt splenic injury. J Chin Med Assoc. 2011 Aug;74(8):341-4. doi: 10.1016/j.jcma.2011.06.005. Epub 2011 Jul
PMID: 21872813
Mangaladevi S Patil 1, Sean Z Goodin 1, Laura K Findeiss 1. Update: Splenic Artery Embolization in Blunt
Abdominal Trauma. Semin Intervent Radiol. 2020 Mar;37(1):97-102. doi: 10.1055/s-0039-3401845. Epub 2020
Mar 4. PMID: 32139975
Sarah Corn 1, Jared Reyes 1, Stephen D Helmer 1 2, James M Haan 1 3. Outcomes Following Blunt
Traumatic Splenic Injury Treated with Conservative or Operative Management. Kans J Med. 2019 Aug
;12(3):83-88. eCollection 2019 Aug. PMID: 31489105
Jing-Jing Rong 1, Dan Liu 1, Ming Liang 1, Qing-Hua Wang 2, Jing-Yang Sun 1, Quan-Yu Zhang 1,
Cheng-Fei Peng 1, Feng-Qi Xuan 1, Li-Jun Zhao 1, Xiao-Xiang Tian 1, Ya-Ling Han 1. The impacts of different
embolization techniques on splenic artery embolization for blunt splenic injury: a systematic review and
meta-analysis. Mil Med Res. 2017 May 30;4:17. doi: 10.1186/s40779-017-0125-6. eCollection 2017. PMID:
Warren Clements 1 2 3, Tim Joseph 4, Jim Koukounaras 4 5, Gerard S Goh 4 5 6, Heather K Moriarty 4 5,
Joseph Mathew 6 7, Tuan D Phan 4. SPLEnic salvage and complications after splenic artery EmbolizatioN for
blunt abdomINal trauma: the SPLEEN-IN study. CVIR Endovasc. 2020 Dec 7;3(1):92. doi:
1186/s42155-020-00185-4. PMID: 33283253
F Cinquantini 1 2, E Simonini 3, S Di Saverio 4, C Cecchelli 5, S H Kwan 6, F Ponti 5, C Coniglio 7, G
Tugnoli 4, P Torricelli 3. Non-surgical Management of Blunt Splenic Trauma: A Comparative Analysis of
Non-operative Management and Splenic Artery Embolization-Experience from a European Trauma Center.
Cardiovasc Intervent Radiol. 2018 Sep;41(9):1324-1332. doi: 10.1007/s00270-018-1953-9. Epub 2018 Apr 18.
PMID: 29671059
Dagmar Morell-Hofert # 1, Florian Primavesi # 2, Margot Fodor 2, Eva Gassner 1, Veronika Kranebitter 2,
Eva Braunwarth 2, Matthias Haselbacher 3, Ulrich Peter Nitsche 4, Stefan Schmid 5, Michael Blauth 3, Dietmar
Öfner 2, Stefan Stättner 6 7. Validation of the revised 2018 AAST-OIS classification and the CT severity index
for prediction of operative management and survival in patients with blunt spleen and liver injuries. Eur Radiol.
Dec;30(12):6570-6581. doi: 10.1007/s00330-020-07061-8. Epub 2020 Jul 21. PMID: 32696255
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