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Application of Microwave Ablation in Laparoscopic Partial Splenectomy

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Predicting Angioembolization Failure in Blunt Splenic Trauma.

Melissa A Kendall¹, Tyler Zander¹, Emily A Grimsley¹

¹Department of Surgery, University of South Florida, Tampa, Fl, USA.

The American Surgeon

|November 14, 2025

Summary

This summary is machine-generated.

Splenic artery angioembolization (SAAE) failure in high-grade blunt splenic injuries is predicted by red blood cell transfusion volume, systolic blood pressure, and injury severity. These factors help identify patients needing further intervention.

Keywords:

Angioembolization Solid Organ Injury Trauma

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Area of Science:

Trauma Surgery
Interventional Radiology
Emergency Medicine

Background:

Splenic artery angioembolization (SAAE) is a key treatment for high-grade blunt splenic injuries.
Nonoperative management is preferred, but SAAE failure necessitates further intervention.

Purpose of the Study:

To determine the failure rates of SAAE in blunt splenic injuries.
To identify predictive factors for SAAE failure (F-EMBO).

Main Methods:

Retrospective review of the TQIP database (2018-2022).
Inclusion of adult patients with AAST Grade III-V blunt splenic injuries undergoing SAAE within 24 hours.
Definition of F-EMBO as requiring splenectomy within 4 days or repeat SAAE.
Utilized univariable analysis and a gradient boosting machine model with SHAP for predictive factor identification.

Main Results:

Out of 6055 patients, 6.0% experienced F-EMBO (2.8% required splenectomy, 3.4% repeat SAAE).
F-EMBO patients had higher rates of anticoagulation, cirrhosis, lower systolic blood pressure, higher pulse rates, and greater red blood cell (RBC) transfusion requirements.
F-EMBO was associated with increased mortality, complications, longer hospital stays, and nonhome discharge rates.

Conclusions:

Red blood cell transfusion volume, systolic blood pressure, injury severity score, age, and pulse rate are significant predictors of SAAE failure.
These factors can guide clinical decision-making and resource allocation for patients with high-grade blunt splenic injuries.