Evaluation of Splenic Artery Embolization Technique for Blunt Trauma.

INTRODUCTION: Evaluate outcomes and radiation exposure across different splenic artery embolization (SAE) techniques for splenic injuries secondary to blunt trauma. METHODS: This retrospective cohort study included patients 18 years of age or older who underwent SAE for splenic injury after blunt trauma from January 2011 to June 2019. RESULTS: Sixty patients underwent angiography for splenic injury after blunt traumatic injury. Forty-four patients were embolized. Seventeen patients underwent proximal SAE, and 23 underwent distal SAE. Four patients had a combination of proximal and distal SAE. Eleven patients had subsequent major complications requiring splenectomy. There was no significant difference in major complication rate when comparing proximal SAE 29.4% versus distal SAE 21.7%. No significant difference was noted across the two groups with respect to age or grade of injury. There was a statistically significant difference (P = 0.004) in fluoroscopy time between the proximal 10.1 ± 4.2 min and distal group 17.8 ± 8.7 min. No statically significant difference was found in major complications when comparing coil versus gel foam embolization. CONCLUSION: Proximal SAE is associated with a significantly lower fluoroscopy time (P = 0.004). Complication rates are similar after proximal and distal SAE. No significant difference was found in major complication rates comparing coil versus gel foam embolization. Minor complications more commonly occurred after proximal embolization with gel-foam.

Embolization for acute gastrointestinal hemorrhage secondary to post-transplant lymphoproliferative disorder.

Gastrointestinal manifestations of post-transplant lymphoproliferative disorder (GI-PTLD) encompasses a spectrum of mucosal inflammation and ulceration that can present as severe acute gastrointestinal bleed. This case report describes a case of GI-PTLD in a 19-year-old female status postcardiac transplant. This patient presented with extensive gastrointestinal hemorrhage secondary to PTLD involving the duodenum. The patient was treated with extensive embolization of the gastroduodenal artery and the pancreaticoduodenal arcades. Embolization was used to mitigate gastrointestinal bleeding, thus preventing the need for surgical resection and extensive reconstruction. This case report demonstrates the utility of embolization as potential therapeutic option in the setting of GI-PTLD in addition to medical and endoscopic therapy.

Vascular lesions of the head and neck: an update on classification and imaging review.

Vascular lesions have a varied appearance and can commonly occur in the head and neck. A majority of these lesions are cutaneous and congenital; however, some may be acquired and malignant. The presentation and clinical history of patients presenting with head and neck lesions can be used to guide further imaging, which can provide important diagnostic and therapeutic considerations. This review discusses the revised International Society for the Study of Vascular Anomalies (ISSVA) classification system for vascular tumors and malformations, as well as explores the most common vascular anomalies including their clinical presentations and imaging findings.