Novel use of the Surefire antireflux device in subtotal splenic embolization

An unstable patient presented with an enlarging splenic hematoma, for whom splenectomy was contraindicated. The decision was made to treat this patient with subtotal splenic embolization. Initial attempts at embolotherapy using a conventional end-hole catheter resulted in a false angiographic end point with reflux into short gastric arteries, likely due to splenic parenchymal pressurization from the hematoma. The Surefire antireflux device (Surefire Medical Inc, Westminster, Colo) was therefore employed. The Surefire device allowed successful subtotal splenic embolization. Whereas it is currently primarily used in hepatic interventional oncology, we have shown that it can be successfully used in other settings to increase embolization efficiency while mitigating nontargeted embolization.