CC BY 4.0 · The Arab Journal of Interventional Radiology 2023; 07(S 01): S1-S41
DOI: 10.1055/s-0043-1763364
Category: Vascular Interventions

Partial Splenic Embolization (PSE) in the Management of Thrombocytopenia Due to Hypersplenism

Ziad Abdul Byekwaso
1   Muhimbili University of Health and Allied Sciences (Muhas), Dar es Salaam, Tanzania
,
Jared M. Alswang
2   Harvard Medical School, Boston, Massachusetts, United States
,
Jade Lerner
3   St. George's University School of Medicine, Grenada, West Indies
,
Balowa Musa
1   Muhimbili University of Health and Allied Sciences (Muhas), Dar es Salaam, Tanzania
,
Azza Naif
4   Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania
,
Erick M. Mbuguje
4   Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania
,
Lulu Fundikira
1   Muhimbili University of Health and Allied Sciences (Muhas), Dar es Salaam, Tanzania
,
Fabian M. Murray Asch
5   Lakeridge Health, Ontario, Canada
,
Vijay Ramalingam
6   Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
,
Fabian M. Laage Gaupp
7   Yale School of Medicine, New Haven, Connecticut, United States
› Author Affiliations
› Further Information
 

Introduction: Hypersplenism with resultant thrombocytopenia is a common complication of chronic liver disease. Recent studies suggest the safety advantages of PSE over the definitive treatment, splenectomy. This review investigates the efficacy of PSE by evaluating its impact on platelet and WBC counts.

Method(s): Tanzanian patients with thrombocytopenia due to hypersplenism underwent PSE at Muhimbili National Hospital from March 2019 to June 2021. Splenic volumes were evaluated preprocedure using CT. Particle embolization of the inferior distal branches of the splenic artery was performed using previously described techniques. The embolization area was measured 1 month postprocedure with CT. Platelet and WBC counts were evaluated preprocedure and 2 weeks, 1 month, and 6 months postprocedure.

Result(s): A total of 12 patients were treated with PSE. The average embolized area was 66.7%. There is a significant increase in platelet and WBC counts at all follow-up intervals (p < 0.05). The embolized area and the change in platelet or WBC count are not correlated. One patient developed a splenic abscess.

Conclusion(s): PSE is a technically feasible, effective, and safe alternative to splenectomy in the management of hypersplenism. This study serves as a foundation for wider adoption in other low-resource settings.



Publication History

Article published online:
09 February 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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