Erschienen in:
01.02.2016 | Interventional
Partial splenic embolization for thrombocytopenia in liver cirrhosis: predictive factors for platelet increment and risk factors for major complications
verfasst von:
Mingyue Cai, Wensou Huang, Chaoshuang Lin, Zhengran Li, Jiesheng Qian, Mingsheng Huang, Zhaolin Zeng, Jingjun Huang, Hong Shan, Kangshun Zhu
Erschienen in:
European Radiology
|
Ausgabe 2/2016
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Abstract
Objectives
To investigate the predictors of platelet increment and risk factors for major complications after partial splenic embolization (PSE) in cirrhosis.
Methods
Between March 2010 and June 2012, 52 cirrhotic patients with severe thrombocytopenia underwent PSE. Multiple variables were analyzed to identify the correlated factors affecting platelet increment and major complications after PSE.
Results
Linear mixed model analysis indicated the splenic infarction ratio (P < 0.001), non-infarcted splenic volume (P = 0.012), and cholinesterase level (P < 0.001) were significantly associated with the platelet increment after PSE. In receiver operating characteristic (ROC) analysis, the cut-off values of the splenic infarction ratio, and non-infarcted splenic volume for achieving an increment of ≥60.0 × 109/L in platelet counts at 1 year after PSE were 64.3 % and 245.8 mL, respectively. After PSE, eight patients developed major complications. Multivariate logistic regression analysis indicated major complications were significantly associated with the infarcted splenic volume (P = 0.024) and Child-Pugh score (P = 0.018). In ROC analysis, the cut-off values of these two factors for discriminating the uncomplicated and complicated were 513.1 mL and 9.5, respectively.
Conclusions
The platelet increment after PSE depends on the splenic infarction ratio, non-infarcted splenic volume and cholinesterase level. But a large infarcted splenic volume and a high Child-Pugh score may cause complications.
Key Points
• The platelet increment after PSE greatly depends on the splenic infarction ratio.
• The non-infarcted splenic volume significantly affects the efficacy of PSE.
• A high cholinesterase level contributes to the improvement of thrombocytopenia after PSE.
• The non-infarcted splenic volume significantly affects the relapse of hypersplenism.
• Complications are significantly associated with the infarcted splenic volume and Child-Pugh score.