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Partial Splenic embolization in the treatment of hypersplenism

Authors: Golfieri R; Modestino F;

Partial Splenic embolization in the treatment of hypersplenism

Abstract

CASE PRESENTATION: A 30-year-old woman with a history of hepatitis B virus-related cirrhosis presented to our institution. In 2013, she underwent transarterial chemoembolization for hepatocellular carcinoma, followed by liver transplantation in August 2014. After surgery, the patient developed portal hypertension and hypersplenism. Partial splenic embolization was proposed. PROCEDURE DESCRIPTION: From a right femoral access, we catheterized the splenic artery to perform diagnostic angiography using a 5-F (1.67-mm) sheath and a 4-F (1.33-mm) cobra catheter. We then decided to go distally to the peripheral intrasplenic branches to perform a more selective embolization. A torqueable DirexionTM Microcatheter and a Fathom®-16 Guidewire were easily advanced through a tortuous splenic branch to perform superselective catheterization of three vessels supplying the upper middle third of the spleen. Subsequently, we embolized those branches using microcoils. After embolization, the patient developed transient abdominal pain, which remitted with administration of pain relief medication. FOLLOW-UP AND DISCUSSION: A postembolization CT scan demonstrated a successful embolization with evidence of partial devascularization of the spleen, with minimal perisplenic and perihepatic fluid and the absence of major complications. The patient showed significant reduction of portal pressure and was discharged a few days later. She was still in good clinical condition at follow-up.

Country
Italy
Keywords

transarterial chemoembolization; hepatocellular carcinoma; liver transplantation; surgery; portal hypertension; hypersplenism; Partial splenic embolization

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Powered by OpenAIRE graph
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
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