Midwest Surgical AssociationComplications arising from splenic artery embolization: a review of an 11-year experience
Section snippets
Methods
Trauma registry (TraumaBase, Clinical Data Management, Evergreen, CO) and medical record information of patients with splenic injuries admitted to Miami Valley Hospital (an American College of Surgeons–verified level I trauma center) between January 2000 and December 2010 were reviewed. Patients were grouped by the type of management of their splenic injury: operative or nonoperative. Individuals who underwent SAE were selected for detailed analysis. Age, sex, length of stay, associated
Results
During the 11-year period studied, 1,383 patients with blunt splenic trauma were admitted to Miami Valley Hospital. There were 298 patients (21.5%) who underwent eventual operative management and 1,085 patients (78.5%) who were successfully managed nonoperatively.
In the NOM group, 91 patients underwent splenic angiography with the intent to perform SAE. Three of these patients did not undergo a completed SAE procedure. In 1 of these 3 patients, with a grade II splenic lesion and active pelvic
Comments
Most of the recent literature regarding SAE has focused on outcomes primarily from the standpoint of successful NOM and the avoidance of splenectomy. Few authors have explored complications of the procedure. Evaluating complications is an important aspect of determining the value of any procedure and determining the risks and benefits.
Our previous study on complications of SAE, which had a small number of patients, reported a major complication rate of 27% and a minor complication rate of 53%.
Conclusions
In summary, SAE is a very useful tool for managing splenic injuries. Major and minor complications can occur and should be included in the risk-benefit analysis. Distal embolization is significantly associated with more major complications.
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