The Efficacy of Transcatheter Arterial Embolization(TAE) in Children With Blunt Splenic Injury

PURPOSE: To evaluate the efficacy of transcatheter arterial embolization(TAE) in children with blunt splenicinjury. MATERIALS AND METHODS: The results of transcatheter splenic arterial embolization in nine children whosuffered splenic injury after blunt abdominal trauma were retrospectively studied. This injury was demonstrated byCT, and the findings were evaluated according to the classification of Mirvis et al. ; two patients were grade 3and seven were grade 4. All were carefully observed in intensive care before embolization. TAE was performed if apatient satisfied the following criteria : (1) transfusion and/or fluid replacement required to maintainhemodynamic stability ; or (2) rapid Hb/Hct decrease ; or (3) both. Splenic function was subsequently estimatedaccording to the results of 99mTc-sulfur colloid scintigraphy and/or CT scanning. RESULT: TAE was suscessful inall nine children. Two were embolized with a coil only, three with gelfoam, and four with gelfoam and a coil.Seven were embolized in the main trunk of the splenic artery and others in both the main trunk and its branches.Splenic function was preserved in all nine children, during follow-up, none suffered rebleeding. CONCLUSION: TAEof the splenic artery can be a safe and effective nonsurgical approach to the management of blunt splenic injuryin children, and can preserve splenic function.

Transcatheter embolization for splanchnic pseudoaneurysm

PURPOSE: To determine the therapeutic effect of transcatheter embolization in the treatment of splanchnicpseudoaneurysm. MATERIALS AND METHODS: This study involved eleven patients who underwent embolization for thetreatment of splanchnic pseudoaneurysm. Nine were men and two were women ; their ages ranged from 8 to 74 (mean,51) years. The etiology of these cases included postoperative pseudoaneurysm(n=4), pancreatitis(n=3), stabinjury(n=1), and suspected infection(n=1), while two cases were uncertain. The locations of the pseudoaneurysmwere the splenic artery(n=4), the gastroduodenal artery(n=3), the hepatic artery(n=2), the celiac artery(n=1), andboth the right renal and lumbar artery(n=1). All patients underwent angiography prior to embolization. Thematerials used during embolization were a microcoil, a 5-cm metallic guide wire, and a detachable balloon. RESULTS: Embolization was successful in all eleven cases. Among nine cases in which follow-up was possible, angiographywas performed in four, and five cases of thrombus were confirmed by abdominal CT. Three of these nine patientsunderwent re-embolization. One patient underwent elective surgery for a pseudocyst due to pancreatitis. CONCLUSION: Transcatheter embolization is a safe and convenient modality for the treatment of splanchnic pseudoaneurysm.