Partial embolization of splenic lienal artery as related to patients with portal hypertension: current state of the issue (literature review)
Abstract
It was presented modern view on partial embolization of splenic artery as related to patients with portal hypertension. The analyzed sources provide evidence that the reduction of splenic bloodstream shows itself as an effective method for the correction of portal hypertension, there is actually a range of proposed methods for its use, however, the optimal medical practice for its realization is still a problematized issue. There is a high chance that infarction at more than 70 % of splenic volume can result in a splenic abscess, in case if the volume of embolized tissue is less than 50 %, clinical effect of the invasion is presumably insufficient. Meanwhile, combination of partial embolization of splenic artery with endoscopic and drug therapy appears as an efficient treatment for gastroesophageal he-
morrhages induced by portal hypertension. Quality and scale of the current research in the field are still insufficient. Conclusively, in order to distinguish the discussed methodology’s efficacy for the treatment of patients with portal hypertension, there is a high need in a multicenter-based international research that would present an extended sample selection for a comprehensive study.
Downloads
References
Maddison FE. Embolic Therapy of Hypersplenism. Invest. Radiol. 1973;8:280-1.
Spigos DG, Jonasson O, Mozes M, Capek V. Partial splenic embolization in the treatment of hypersplenism. Am. J. Roentgenol. 1979;132:777-82.
Nikishin LF, Popik MP. Klinicheskie lekcii po rentgenehndovaskulyarnoj hirurgii. Lvov;1996. 164 р. [In Russian].
Nikishin LF, Kondratyuk VA. Endovaskulyarnoe lechenie oslozhnenij portalnoj gipertenzii [In Russian]. Klin. khirurhiia [In Ukrainian]. 2002;5-6.
Mokdad AA, et al. Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis. BMC Medicine. 2014;12:145. doi:10.1186/s12916-014-0145-y.
Інтернет-публікація. Available from: http://www.transplant-observatory.org/data-charts-and-tables/.
Інтернет-публікація. Available from: https://optn.transplant.hrsa.gov/data/view-data-reports/national-data/#.
Gu JJ, He XH, Li WT, et al. Safety and efficacy of splenic artery coil embolization for hypersplenism in liver cirrhosis. Acta Radiol. 2012 Oct 1;53(8):862-7. doi: 10.1258/ar.2012.110639.
He XH, Gu JJ, Li WT, et al. Comparison of total splenic artery embolization and partial splenic embolization for hypersplenism. World J Gastroenterol. 2012 Jun 28;18(24):3138-44. doi: 10.3748/wjg.v18.i24.3138.
Ahuja C, Farsad K, Chadha M. An overview of splenic embolization. Am. J. Roentgenol. 2015 Oct;205(4):720-5. doi: 10.2214/AJR.15.14637.
Pang X, Li T, Wang C. Splenic artery embolization with detachable balloons for hypersplenism. J. Int. Med. Res. 2018 Oct;46(10):4111-9. doi: 10.1177/0300060518786419
Assal F, El Kassas M, Esmail E, et al. Microwave ablation in the spleen versus partial splenic artery embolisation: A new technique for hypersplenism in cirrhosis. Arab. J. Gastroenterol. 2017 Mar;18(1):25-9. doi: 10.1016/j.ajg.2017.01.001.
DuBois B, Mobley D, Chick JFB, Srinivasa RN, Wilcox C, Weintraub J. Efficacy and safety of partial splenic embolization for hypersplenism in pre- and post-liver transplant patients: A 16-year comparative analysis. Clin. Imaging. 2018 Nov 27;54:71-7. doi: 10.1016/j.clinimag.2018.11.012.
Wang YB, Zhang JY, Zhang F, Zhao Y, Gong JP. Partial splenic artery embolization to treat hypersplenism secondary to hepatic cirrhosis: A meta-analysis. Am. Surg. 2017 Mar 1;83(3):274-83.
Cai M, Huang W, Lin C, et al. Partial splenic embolization for thrombocytopenia in liver cirrhosis: predictive factors for platelet increment and risk factors for major complications. Eur. Radiol. 2016 Feb;26(2):370-80. doi: 10.1007/s00330-015-3839-4.
Wang P, Liu R, Tong L, et al. Partial splenic embolization has beneficial effects for the management of gastroesophageal variceal hemorrhage. Saudi J Gastroenterol. 2016 Nov;22(6):399-406. doi:10.4103/1319-3767.195553. Review.
Buechter M, Kahraman A, Manka P, et al. Partial spleen embolization reduces the risk of portal hypertension-induced upper gastrointestinal bleeding in patients not eligible for TIPS implantation. PLoS One. 2017 May 11;12(5):e0177401. doi: 10.1371/journal.pone.0177401.
This work is licensed under a Creative Commons Attribution 4.0 International License.
