Splenic trauma: endovascular treatment approach

Area of Science:

• Trauma Surgery
• Interventional Radiology
• Spleen Preservation

Background:

• Blunt abdominal trauma frequently injures the spleen, necessitating organ preservation for immune function.
• Splenic preservation is vital to prevent overwhelming infections from encapsulated organisms.
• Non-operative management (NOM) is preferred for splenic injuries, with Splenic Artery Embolization (SAE) as a key component.

Purpose of the Study:

• To review the history, indications, and techniques of SAE in blunt splenic trauma.
• To evaluate the effectiveness and outcomes of SAE in spleen salvage.
• To discuss the role of SAE within a multidisciplinary trauma management strategy.

Main Methods:

• Review of endovascular approaches for SAE in splenic trauma.
• Description of various embolic agents (particles, coils, vascular plugs).
• Analysis of proximal, distal, and combined embolization strategies.

Main Results:

• SAE significantly improves NOM success rates and spleen salvage, achieving over 85% overall.
• Failure rates correlate with higher injury severity, but complications remain low (rebleeding, infarction, abscess).
• Immune function is generally preserved post-SAE, though further research into immune changes is needed.

Conclusions:

• SAE is an effective endovascular technique for managing blunt splenic trauma, enhancing spleen salvage.
• It plays a critical role in NOM, allowing spleen healing while maintaining perfusion.
• SAE is an integral part of modern multidisciplinary trauma care.