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[Splenic artery embolization in hematologic diseases in children]
1Clinique de chirurgie Infantile et d'orthopédie de Iagi, Roumanie.
Chirurgie Pediatrique
|January 1, 1987
Summary
Partial arterial splenic embolization (PASE) effectively treats pediatric hypersplenism, offering an alternative to splenectomy. This minimally invasive procedure uses absolute alcohol and shows sustained hematological improvement in most patients.
Area of Science:
- Pediatric Hematology
- Interventional Radiology
Background:
- Splenectomy has been the traditional treatment for pediatric hypersplenism.
- Partial arterial splenic embolization (PASE) has emerged as a viable alternative over the past four years.
Observation:
- PASE involves selective catheterization of the splenic artery under local anesthesia, embolizing approximately two-thirds of the spleen.
- Absolute alcohol (90 degrees) was utilized as the primary embolizing agent in most cases.
- Indications included congenital hemolytic anemia, thrombocytopenia, and portal hypertension with secondary hypersplenism.
Findings:
- PASE achieved hypersplenism remission in all but one patient, with results sustained for 1-3 years.
- The procedure was generally well-tolerated, with common side effects including fever and abdominal pain.
- Complications occurred in three cases, including excessive embolization requiring splenectomy and subcapsular hematoma requiring drainage.
Implications:
- PASE is a safe and effective alternative to splenectomy for managing pediatric hypersplenism.
- Absolute alcohol is a suitable embolizing agent for PASE in children, a novel application.
- This approach offers significant clinical benefits for children with hematological disorders causing hypersplenism.