CIO 2022-18 Role of Splenic Artery Embolization in the Management of Various Splenic Pathologies

Purpose: To evaluate technical and clinical success, complications of splenic artery embolization in management of different splenic pathologies.

Materials and Methods: We prospectively reviewed 294 patients in whom splenic artery embolization was performed between July 2015 and January 2022. Among the 294 patients, 126 patients had splenic artery pseudoaneurysms, 119 patients had hypersplenism, and 49 patients had splenic hemangiomas. Splenic artery embolization was done using N-butyl 2-cyanoacrylate (NBCA) glue, polyvinyl alcohol particles, and/or coils depending on the pathology. We evaluated for technical and clinical success, complications of the procedure, and recurrence of the pathology. The interventional procedure was done in the cath lab using a GE Innova 41001Q machine.

Results: Successful embolization of the splenic artery was achieved in all patients. Complications included development of splenic infarct in 15 cases of splenic artery pseudoaneurysm following passage of NBCA glue to the smaller branches of the splenic artery. During follow-up, none of the patients developed recurrence of their primary pathology.

Conclusions: Splenic arterial embolization is a minimally invasive and effective management option for different vascular and nonvascular splenic pathologies. It is being increasingly used as an alternative to surgeries in management of various splenic pathologies.