Partial splenic embolization in patients with idiopathic portal hypertension

Maurizio Romano, Angela Giojelli, Gaetano Capuano, Domenico Pomponi, Marco Salvatore

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate the effectiveness of partial splenic embolization (PSE) in patients with idiopathic portal hypertension (IPH) in reducing variceal bleeding episodes, splenomegaly and thrombocytopenia. Materials and methods: Six patients (2M, 4F, mean age 30.3 years) with IPH presenting with splenomegaly, thrombocytopenia and recurrent variceal bleeding were treated with PSE using gelatin sponge (four patients) or Contour particles (two patients) as embolization material. Results: PSE was performed successfully in all cases; 3F coaxial microcatheters were necessary in two patients due to extreme splenic artery tortuosity. The average amount of devascularized parenchyma at CT 1 week after PSE was 71%. Splenomegaly and thrombocytopenia improved in all cases, with a mean platelet count increase of 120 000/mm 3 and an average 68% reduction of spleen volume at follow up. Variceal bleeding did not recur after PSE. Esophageal or gastroesophageal varices disappeared (one patient) or significantly reduced (five patients) at endoscopic controls. No significant complications were noted. The follow up was of at least 18 months in all patients; mean follow up was 28.2 months. Conclusion: In patients with IPH PSE can be effective in preventing variceal bleedings, in reducing spleen volume and in significantly increasing platelet count; therapeutic results were durable in our population.

Original languageEnglish
Pages (from-to)268-273
Number of pages6
JournalEuropean Journal of Radiology
Volume49
Issue number3
DOIs
Publication statusPublished - Mar 2004

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Keywords

  • Embolization
  • Interventional
  • Portal hypertension
  • Radiology
  • Therapeutic

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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