Sage Journals: Discover world-class research

Abstract

Background

Partial splenic artery embolization (PSE) is an effective treatment modality for patients with hypersplenism. It is less invasive and has a quicker recovery compared with surgical procedures. PSE is usually performed using a femoral artery approach that requires bedrest for a few hours, which is rarely the case for transradial PSE.

Purpose

To compare the transradial and transfemoral approaches for embolization of spleen in patients with hypersplenism.

Material and Methods

In all, 84 patients with hypersplenism who required PSE were recruited. They were randomly divided into two groups on the basis of the procedure followed: the transradial approach (R-PSE, n = 39) or transfemoral approach (F-PSE, n = 45). Technical success, puncture rate, total procedure time, X-ray exposure time, length of stay in hospital (LOS), and complications of the two groups were recorded.

Results

The procedure time, X-ray exposure time, and LOS were found to be lower in the R-PSE group than in the F-PSE. However, this difference was not statistically significant.

Conclusion

The transradial artery approach for PSE in patients with hypersplenism is feasible with no major complications as compared to the femoral approach.

Keywords

Partial splenic embolization hypersplenism cirrhosis radial artery approach transfemoral approach

Get full access to this article

View all access options for this article.

References

Masada

Tanaka

Sakaguchi

. Coils versus gelatin particles with or without intraarterial antibiotics for partial splenic embolization: a comparative evaluation. J Vasc Interv Radiol 2014; 25: 852–858.

Hayashi

Beppu

Masuda

. Large splenic volume may be a useful predictor for partial splenic embolization-induced liver functional improvement in cirrhotic patients. J Hepatobiliary Pancreat Sci 2014; 21: 51–57.

Amin

El-Gendy

Dawoud

. Partial splenic embolization versus splenectomy for the management of hypersplenism in cirrhotic patients. World J Surg 2009; 33: 1702–1710.

Zhan

Wang

. laparoscopic splenectomy for hypersplenism secondary to liver cirrhosis and portal hypertension. World J Gastroenterol 2014; 20: 5794–5780.

Coelho

Balbinot

Nitsche

. Chang in platelet count in patients with hypersplenism subjected to liver transplantation. Arg Gastroenterol 2011; 48: 175–178.

Liang

Gao

Zhang

. Microwave ablation in the spleen for treatment of secondary hypersplenism: a preliminary study. Am J Roentgenol 2011; 196: 692–696.

Matsuoka

Yamamoto

Okuma

. CT-guided percutaneous radiofrequency ablation of spleen: a preliminary study. Am J Roentgenol 2007; 188: 1044–1046.

Zhu

Mei

. High-intensity focused ultrasound ablation for treatment of hepatocellular carcinoma and hypersplenism: preliminary study. J Ultrasound Med 2013; 32: 1855–1862.

Omer

Zara

Iacobescu

. Partial splenic embolization for hypersplenism in cirrhotic patients. A case series. J Gastrointestin Liver Dis 2014; 23: 215–218.

10.

. Safety and efficacy of splenic artery coil embolization for hypersplenism in liver cirrhosis. Acta Radiol 2012; 53: 862–867.

11.

Abdella

Abd-El-Moez

Abu El-Maaty

. Role of partial splenic arterial embolization for hypersplenism in patients with liver cirrhosis and thrombocytopenia. Indian J Gastroenterol 2010; 29: 59–61.

12.

Sankararaman

Velayuthan

Vea

. Severe gastric variceal bleeding successfully treated by emergency splenic artery embolization. Pediatr Int 2013; 55: e42–45.

13.

Araten

Iori

Brown

. Selective splenic artery embolization for the treatment of thrombocytopenia and hypersplenism in paroxysmal nocturnal hemoglobinuria. J Hematol Oncol 2014; 7: 1–9.

14.

Smith

Ray

. Splenic artery embolization as an adjunctive procedure for portal hypertension. Semin Intervent Radiol 2012; 29: 135–139.

15.

Pinter

Cagiannos

Ruzsa

. Report on initial experience with transradial access for carotid artery stenting. J Vase Surg 2007; 45: 1136–1141.

16.

Folmar

Sachar

Mann

. Transradial approach for carotid artery stenting: a feasibility study. Catheter Cardiovasc Interv 2007; 69: 355–361.

17.

Asif

Sarkar

. Three-digit Allen’s test. Ann Thorac Surg 2007; 84: 686–687.

18.

Higgs

Macafee

Braithwaite

. The Seldinger technique: 50 years on. Lancet 2005; 366: 1407–1409.

19.

Chuang

Lin

. A novel method for the angiographic estimation of the percentage of spleen volume embolized during partial splenic embolization. Eur J Radiol 2013; 82: 1260–1265.

20.

Naritaka

Shiozawa

Shimakawa

. Transradial approach for partial splenic embolization in patients with hypersplenism. Hepatogastroenterology 2007; 54: 1850–1853.

21.

Resnick

Kim

Patel

. No. 139-Uterine artery embolization using a transradial approach: initial experience and technique. J Vasc Interv Radiol 2014; 25: 443–447.

22.

Kwan

Chaudhry

Huang

. Approaches for dislodged stent retrieval during transradial percutaneous coronary interventions. Catheter Cardiovasc Interv 2013; 81: E245–249.

23.

Rodriguez-Leor

Fernandez-Nofrerias

Carrillo

. Results of primary percutaneous coronary intervention in patients ≥75 years treated by the transradial approach. Am J Cardiol 2014; 113: 452–456.

Partial splenic embolization of patients with hypersplenism by transradial or transfemoral approach: a prospective randomized controlled trial