On-line monitoring of sequential blood flow reduction during splenic embolization

Partial embolization of the spleen has been well established for the treatment of hypersplenism. A weakness of the technique is the lack of an objective method to quantitate the flow reduction during the procedure. The video dilution technique (VDT) has earlier been used to measure blood flow in regional arteries using video cassette replay. By adapting the VDT concept of relative flow to digital subtraction angiography, it is possible to calculate the flow reduction instantly following each injection of embolic material. We present a case of partial splenic embolization where the flow in the splenic artery was reduced to a predetermined level of 50 per cent of baseline flow. The clinical results were excellent. By observing the clinical results of partial embolization, terminated at different levels of flow reduction, it will be possible to optimize the results and prevent overembolization.