Distal embolization versus combined embolization techniques for blunt splenic injuries: comparison of the efficacy and complications

// Yon-Cheong Wong 1 , Cheng-Hsien Wu 1 , Li-Jen Wang 1 , Huan-Wu Chen 1 , Kuo-Ching Yuan 2 , Being-Chuan Lin 2 , Yu-Pao Hsu 2 and Shih-Ching Kang 2 1 Emergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Chang Gung University, Taoyuan City, Taiwan 2 Division of Trauma and Emergency Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Chang Gung University, Taoyuan City, Taiwan Correspondence to: Yon-Cheong Wong, email: ycwong@cgmh.org.tw Keywords: embolization technique, splenic injuries, efficacy, spleen infarct, splenic abscess Received: March 24, 2017 Accepted: September 20, 2017 Published: October 05, 2017 ABSTRACT Comparable failure rates of distal or proximal transcatheter arterial embolization (TAE) techniques for blunt splenic injuries have been reported. This study is to investigate the efficacy and complication of combining both TAE techniques. We included 26 patients of blunt splenic injuries for TAE therapy and randomized them into distal TAE and combined TAE groups. A prospective study was performed to compare their demographics, clinical parameters, hemograms, post-TAE splenic infarct volumes, splenic abscess and pancreatitis between the two groups. Of 26 patients, 17 received distal TAE, 9 received combined TAE. Their basic demographics, clinical parameters and hemograms did not differ. Mean systolic blood pressure of all patients was significantly elevated after TAE at 24 hours later. Three patients of distal TAE group had residual pseudoaneurysms in follow up. They were considered failures in distal TAE group as opposed to all successes in combined TAE group. The risk difference of failure of distal TAE was 17.6%. None developed post-TAE splenic abscess, massive splenic infarct or pancreatitis. The mean splenic infarct volume of distal TAE (10.9%) versus combined TAE groups (6.6%) was not significant ( p = 0.481). Combined TAE is effective and safe to decrease the failure rates of non-operative management for blunt splenic injuries.