From embolization to access: Wire-enabled crossing of a coil pack for targeted distal re-treatment

This brief report describes a unique case in which distal splenic embolization was achieved by traversing a previously placed coil pack in the proximal splenic artery. Following orthotopic liver transplantation, A 65-year-old woman developed poor hepatic arterial flow which was initially managed by proximal splenic artery coil embolization to improve hepatic perfusion. Her postoperative course also notable for persistent thrombocytopenia and splenomegaly. Distal splenic access was obtained by crossing the previously placed coil pack with a hydrophilic wire which enabled successful distal administration of liquid embolic. This report highlights the feasibility of crossing a coil pack with a wire to facilitate targeted re-embolization.