Splenic artery embolization for traumatic and non-traumatic splenic injury

Aims: The aim of this retrospective study is to identify clinical factors associated with the clinical outcome of both traumatic and non-traumatic patients who underwent splenic artery embolization (SAE) in the treatment of splenic hemorrhage. Methods: Of 84 patients with blunt splenic injuries identified at our institution, 43 patients underwent SAE for management of bleeding. Additionally, 14 patients underwent SAE for non-traumatic splenic injuries. The following factors were assessed to determine their relationship to procedure outcomes: age, Shock Index (SI), hemoglobin (Hb), hematocrit (Ht), prothrombin time (PT), systolic blood pressure (BP), BP changes during SAE, blood transfused by the end of SAE. For blunt splenic injuries, the American Association for the Surgery of Trauma (AAST) grade and Injury Severity Score (ISS) were also assessed. Results: The overall good clinical outcome rate was 79.1% (34/43) for traumatic patients and 92.8% (13/14) for non-traumatic patients. Lower Hb, lower Ht, lower BP, less increase in BP during SAE and increased requirement for blood transfusions by the end of SAE were associated with poor clinical outcome of the patients with blunt splenic injury. Conclusion: We revealed several factors associating with the success rate for SAE. These results may indicate the treatment of choice in patients with traumatic and non-traumatic splenic injuries.