Partial splenic artery embolization in portal hypertension patients with hypersplenism: Two interval-spaced sessions’ technique

Purpose

To evaluate the ability of interval spaced sessions of transcatheter partial splenic artery embolization (PSE) to avoid the potential post procedure major complications, in portal hypertension patients with hypersplenism.

Material and methods

The study included 50 patients (39 male and 11 females). All patients had liver cirrhosis and portal hypertension with hypersplenism and hyperactive bone marrow. All patients underwent PSE in two sessions separated at least by 1 month interval. Immediate, short and intermediate term follow-up for 1 year were done.

Results

We had no post procedure mortality. None of the patients developed septic shock, splenic abscess or needed emergency surgery. Ten of our patients developed subcapsular collections which were treated conservatively. All of our patients showed significant increase in the thrombocyte count after the first session which becomes remarkable after the second session and remained at appropriate levels during the follow up period.

Conclusion

PSE using two (interval-spaced) sessions with careful pre- and post procedure medications and care; is really effective non surgical minimally invasive procedure in avoiding the potential post procedure complications while achieving remarkable hematologic response on controlling hypersplenism in cirrhotic patients with portal hypertension.