Complications arising from splenic artery embolization: a review of an 11-year experience

Am J Surg. 2013 Mar;205(3):250-4; discussion 254. doi: 10.1016/j.amjsurg.2013.01.003. Epub 2013 Jan 31.

Abstract

Background: Splenic artery embolization (SAE) is a staple adjunct in the management of blunt splenic trauma. We examined complications of SAE over an 11-year period.

Methods: Patients who underwent SAE were identified. Demographic data and the location of the SAE-proximal, distal, or combined-were noted. Major and minor complications were identified.

Results: Of 1,383 patients with blunt splenic trauma, 298 (21.5%) underwent operative management, and 1,085 (78.5%) underwent nonoperative management (NOM). SAE was performed in 8.1% of the NOM group. Major complications which occurred in 14% of patients, included splenic abscesses, infarction, cysts, and contrast-induced renal insufficiency. Three-fourths of patients with major complications underwent distal embolization. There were more complications in patients who underwent distal embolization (24% distal vs 6% proximal alone; P = .02). Minor complications, which occurred in 34% of patients, included left-sided pleural effusions, coil migration, and fever.

Conclusions: SAE is a useful tool for managing splenic injuries. Major and minor complications can occur. Distal embolization is associated with more major complications.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography
  • Child
  • Contrast Media
  • Embolization, Therapeutic / adverse effects*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Spleen / blood supply*
  • Spleen / diagnostic imaging
  • Spleen / injuries*
  • Splenic Artery*
  • Treatment Outcome
  • Wounds, Nonpenetrating / diagnostic imaging
  • Wounds, Nonpenetrating / surgery
  • Wounds, Nonpenetrating / therapy*

Substances

  • Contrast Media