Angio-Embolization in Pediatric Splenic Trauma

Area of Science:

• Pediatric Trauma Surgery
• Interventional Radiology
• Surgical Outcomes

Background:

• Pediatric splenic trauma management has evolved, with increasing interest in organ-sparing techniques.
• Angioembolization offers a minimally invasive option to control hemorrhage and preserve splenic function.
• Understanding trends and patient factors is crucial for optimizing treatment strategies.

Purpose of the Study:

• To evaluate current trends in angioembolization for pediatric splenic trauma.
• To identify factors associated with angioembolization and splenectomy.
• To assess spleen salvage rates and overall splenectomy incidence.

Main Methods:

• Retrospective analysis of pediatric splenic trauma patients (ages 1-18) from the 2021-2023 National Trauma Data Bank.
• Calculation of angioembolization, spleen salvage, and splenectomy rates across age groups.
• Logistic regression analysis to determine associations between patient characteristics and treatment outcomes.

Main Results:

• Angioembolization was used in 1.80% of cases, with a 90.74% spleen salvage rate.
• Splenectomy rates decreased annually from 2021-2023, while angioembolization rates increased.
• Older age, higher injury severity, greater blood transfusion, and lower blood pressure were linked to both angioembolization and splenectomy.

Conclusions:

• Angioembolization is an effective, albeit infrequent, treatment for pediatric splenic trauma.
• It is predominantly used in older, hemodynamically unstable children.
• The trend favors increased angioembolization and decreased splenectomy over time.