[Partial splenic embolization in the treatment of hypersplenism. Long-term results]

In order to assess long term evolution of partial splenic embolization (PSE), 21 patients with hypersplenism treated by this technique from January 1984 to December 1992 have been reviewed. Between 50 and 90% of the splenic parenchyma was embolized in these patients. The follow-up period ranged between 12 and 103 months (mean = 32 months). Remaining splenic tissue was evaluated through sequential hematologic, ultrasonic and gammagraphic studies. After one year post-embolization white blood cells and platelets showed normal values. Five years later the mean values for these two parameters was lower but within the normal range. The mean reduction of splenic mass as estimated by ultrasound and gamma graphic studies was of 40% at one year and 17% at five years. Our results show that SPE can control hypersplenism, specially during the first years, but there is a tendency to a decrease in the leucocyte and platelet counts after five years. A regeneration of the splenic mass occurs in the long run after embolization. In our patients a relation between splenic regeneration and hypersplenism could not be demonstrated.