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Related Experiment Video

Updated: Jan 7, 2026

Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
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Splenectomy Increases CTEPH Risk and Modifies Clinical Features of Acute Pulmonary Embolism.

Darren White1, Brian W Locke1,2, Brittany M Scarpato1,2

  • 1Division of Pulmonary and Critical Care Medicine University of Utah Salt Lake City Utah USA.

Pulmonary Circulation
|December 31, 2025
PubMed
Summary

Prior splenectomy is linked to a higher risk of developing chronic thromboembolic pulmonary hypertension (CTEPH) after acute pulmonary embolism (PE). Splenectomized patients with PE present differently, suggesting a role in CTEPH development.

Keywords:
pulmonary embolismpulmonary hypertensionsplenectomy

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Area of Science:

  • Cardiology
  • Pulmonary Medicine
  • Hematology

Background:

  • Chronic thromboembolic pulmonary hypertension (CTEPH) pathophysiology remains unclear.
  • Acute pulmonary embolism (PE) can evolve into CTEPH.
  • Splenectomy is a potential risk factor for CTEPH development.

Purpose of the Study:

  • To investigate the association between prior splenectomy and CTEPH.
  • To clarify mechanisms linking acute PE to CTEPH.
  • To examine clinical features of acute PE in patients with and without splenectomy.

Main Methods:

  • Two observational cohorts were analyzed.
  • Frequency of splenectomy was compared in CTEPH, PE, and control groups.
  • Clinical presentation of acute PE was compared between splenectomized and non-splenectomized patients.

Main Results:

  • Splenectomy history was significantly more frequent in CTEPH patients compared to PE patients (OR 4.3).
  • This association persisted when comparing CTEPH patients to PE patients without a provoking factor (OR 5.3).
  • Acute PE patients with prior splenectomy showed more subacute symptoms, distal PE locations, and less deep venous thrombosis (DVT).

Conclusions:

  • Prior splenectomy is associated with an increased risk of CTEPH.
  • Splenectomy modifies clinical features of acute PE, potentially influencing CTEPH development.
  • Further research is needed to elucidate the exact mechanisms by which splenectomy contributes to CTEPH.