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Percutaneous nonvascular splenic intervention: a 10-year review
Brian C Lucey1, Giles W Boland, Michael M Maher
1Department of Radiology, Division of Abdominal Imaging and Intervention, Massachusetts General Hospital, White 270, 55 Fruit St., Boston, MA 02114, USA.
AJR. American Journal of Roentgenology
|November 20, 2002
Summary
Percutaneous splenic interventions, including biopsy and drainage, demonstrate high success rates and acceptable safety profiles. Careful patient selection and pre-procedure evaluation are crucial, especially for patients with potential vascular splenic lesions.
Area of Science:
- Radiology
- Interventional Radiology
- Gastroenterology
Background:
- Percutaneous splenic interventions are increasingly utilized for diagnostic and therapeutic purposes.
- Evaluating the safety and efficacy of these procedures is essential for clinical practice.
Purpose of the Study:
- To retrospectively review experiences with percutaneous splenic interventions.
- To assess the success and complication rates of these procedures.
Main Methods:
- Retrospective analysis of 39 imaging-guided percutaneous splenic procedures in 38 patients (1990-2000).
- Procedures included splenic biopsy (n=24), fluid aspiration (n=8), and fluid drainage (n=7).
- Guidance modalities included sonography (n=28) and CT (n=11).
Main Results:
- High success rates: splenic biopsy (91%), fluid aspiration (100%), fluid drainage (86%).
- Overall complication rate was 10.3%, with three patients requiring splenectomy due to massive bleeding.
- Complications were associated with unrecognized vascular tumors and thrombocytopenia.
Conclusions:
- Percutaneous splenic biopsy is safe and valuable for diagnosis.
- Percutaneous catheter drainage of splenic abscesses is successful, reserving splenectomy for failures.
- Pre-procedure assessment of coagulation parameters is vital, particularly for potential vascular splenic lesions.