Clinical Outcomes in Patients with Preprocedural Hepatofugal Portal Venous Flow Undergoing Partial Splenic Artery Embolization for Hypersplenism

Background: Several previous studies suggested that hepatofugal flow should be considered as a contraindication to partial SAE. In this study we aimed at evaluation of the clinical outcomes of partial splenic artery embolization (SAE) in patients with post cirrhotic hypersplenism and preprocedural hepatofugal portal venous flow. Method(s): From January 2017 to October 2018, 40 patients with hypersplenism and hepatofugal portal venous flow underwent partial SAE. We considered 40 patients with hypersplenism and hepatopedal portal venous flow who are age-, gender- and Child Pugh classification matched case controls undergoing SAE for hypersplenism during the same period (control group). Perioperative and clinical outcomes after 1 year of follow up were compared between the two groups. Result(s): No significant differences were detected in the age, sex and laboratory investigations between the two groups (p ≥ 0.350). Mortality rate was zero in both groups. No significant difference were found regarding the postoperative complications between the two groups (p ≥ 0.250). Regarding the long-term clinical, laboratory and radiological outcomes, no significant differences were noticed between the two groups (p ≥ 0.3). Conclusion(s): Partial SAE in post cirrhotic hypersplenism patients with hepatofugal portal venous flow can be performed safely without significant complications and shouldn’t be considered as a contraindication for partial SAE in well selected patients with child’s a cirrhosis.

Publication History

Article published online:
11 May 2021