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Coil embolization of the splenic artery: impact on splenic volume
Stephen R Preece1, Stacey M Schriber1, Kingshuk R Choudhury2
1Division of Vascular and Interventional Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710.
Insights
Coil embolization of the splenic artery can reduce spleen size, especially when performed distally. Proximal embolization showed insignificant changes in splenic volume.
Area of Science:
- Interventional Radiology
- Medical Imaging
- Surgical Oncology
Background:
- Splenic artery embolization (SAE) is a procedure used for various conditions.
- Assessing the impact of SAE on splenic volume is crucial for understanding its effects.
Purpose of the Study:
- To determine the impact of coil embolization of the splenic artery on splenic volume.
- To evaluate the influence of coil pack location on post-embolization splenic volume.
Main Methods:
- Retrospective study of 148 patients undergoing SAE over 8 years.
- 60 patients had pre- and post-SAE contrast-enhanced CT scans analyzed for splenic volume.
- Comparison with a trauma control group (39 patients) without intervention.
Main Results:
- SAE in trauma patients showed an insignificant decrease in mean splenic volume (224 cm³ to 190 cm³).
- Nontrauma patients showed a trend towards decreased splenic volume (474 cm³ to 399 cm³).
- Distal coil embolization significantly reduced splenic volume in both trauma and nontrauma groups, unlike proximal embolization.
Conclusions:
- Distal splenic artery coil embolization leads to a modest but significant decrease in splenic volume.
- Proximal embolization resulted in insignificant changes in splenic volume.
- SAE did not lead to persistent Howell-Jolly bodies or require repeat procedures.
Purpose:
To determine the impact of coil embolization of the splenic artery on splenic volume based on computed tomography (CT) imaging.
Materials And Methods:
Splenic artery embolization (SAE) was performed in 148 consecutive patients over an 8-year period in an institutional review board-approved retrospective study. Of these, 60 patients (36 men; mean age, 49 y) had undergone contrast-enhanced CT before and after SAE with a mean time interval of 355 days. Pre- and postembolization splenic volumes were calculated with volume-rendering software. Presence of Howell-Jolly bodies was ascertained on laboratory tests. A trauma control group consisted of 39 patients with splenic laceration and follow-up CT but no splenic intervention.
Results:
SAE in trauma patients resulted in an insignificant decrease in mean spleen size from 224 cm(3) to 190 cm(3) (P = .222). However, postembolization splenic volume was significantly smaller than follow-up volume in the trauma control group (353 cm(3); P < .001). In nontrauma patients, the mean splenic volume decreased from 474 cm(3) to 399 cm(3) after SAE (P = .068). Multivariable analysis revealed that coil pack location was the only factor significantly affecting resultant splenic volume (P = .016). For trauma and nontrauma patients, distal embolization resulted in significant splenic volume loss (P = .034 and P = .013), whereas proximal embolization did not. No patients had persistent circulating Howell-Jolly bodies after SAE. No patients required repeat embolization or splenectomy.
Conclusions:
Coil embolization of the splenic artery resulted in a modest but significant decrease in splenic volume when performed distally; proximal embolization resulted in an insignificant volume change.
