The impact of splenic artery embolization on the management of splenic trauma: an 8-year review

Am J Surg. 2009 Mar;197(3):337-41. doi: 10.1016/j.amjsurg.2008.11.017.

Abstract

Background: Splenic artery embolization (SAE) is an adjunct to nonoperative management (NOM) of splenic injuries. We reviewed our experience with SAE to identify its impact on splenic operations.

Methods: Patients admitted with splenic injuries over an 8-year period were identified and the initial method of management noted (simple observation, SAE, or splenic surgery). The first 4 years (period 1) during which SAE was introduced was compared with the latter 4 years (period 2) when it was used frequently.

Results: There were 304 patients in period 1 and 416 in period 2. NOM was initial management in 59.9% in period 1% and 60.1% in period 2 (P = 1.0) and failure rates were 5.3% versus 2.9%, respectively (P = .12). More SAE procedures were performed in period 2 -- 13.7% versus 4.9% (P < or = .001) -- and there was a reduction in the proportion of splenic operations -- 35.2% versus 26.2% (P <.01).

Conclusions: SAE is associated with a reduction in splenic operations, although it did not alter the failure rate of NOM.

MeSH terms

  • Abdominal Injuries / therapy*
  • Adolescent
  • Adult
  • Embolization, Therapeutic*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Spleen / injuries*
  • Splenic Artery*
  • Young Adult