ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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1/2022
vol. 87
 
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Interventional radiology
abstract:
Original paper

Evaluation of the effectiveness of partial splenic endovascular embolization in patients with refractory thrombocytopaenia

Maciej Rabczyński
1
,
Monika Fenc
1
,
Jarosław Dybko
2
,
Jerzy Garcarek
3
,
Marcin Miś
3
,
Maciej Guziński
3

1.
Department of Angiology, Hypertension, and Diabetology, Wroclaw Medical University, Wroclaw, Poland
2.
Department of Hematology and Cellular Transplantation, Lower Silesian Oncology Center, Wroclaw, Poland
3.
Department of Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
© Pol J Radiol 2022; 87: e369-e374
Online publish date: 2022/07/06
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Introduction
Partial splenic endovascular embolization (PSEE) could be an option for patients with thrombocytopaenia (TCP). We selected a group of 22 patients diagnosed with refractory TCP to undergo PSEE, and we followed them for detailed analysis.

Material and methods
Twenty-two patients aged 27-75 years (mean 46.5 ± 3.5 years) underwent PSEE, and 5 participants underwent a second PSEE due to the lack of effectiveness after the first procedure. A total of 27 PSEEs were performed. A semi-quantitative scale was used to assess the severity of the post-embolization syndrome. The percentage of spleen parenchyma excluded from circulation was 30-70%. We used the mixture of Histoacryl N-butyl cyanoacry­late glue and Lipiodol in 10 cases, spirals in 10 cases, and polyvinyl alcohol in 7 cases, for the embolization.

Results
The mean value of platelet count (PLT) before procedure increased from 22.0 ± 15.0 to 87.7 ± 67.9 (p < 0.05) in a mean period of 194 days. In 2 cases severe post-embolization syndrome was observed. Closure less than 50% of the spleen circulation was associated with poorly expressed post-embolization symptoms. Serious complications occurred in 1 patient (3.5%). A strong positive correlation (r = 0.8, p < 0.05) was found between C-reactive protein (CRP) and the severity of post-embolization syndrome. Increased symptoms of post-embolization syndrome were also associated with a significant increase in hospitalization time – 27.0 vs. 7.2 days (r = 0.66, p < 0.05).

Conclusions
Partial endovascular embolization of the spleen (PSEE) may be a valuable therapeutic option for patients with refractory TCP. PSEE is a safe method with a low complication rate.

keywords:

embolization, thrombocytopaenia, splenic artery




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