The prognosis of liver cirrhosis depends on the presence of its major complications as well as on other factors such as hypersplenism with thrombocytopenia. Partial splenic embolization is an effective interventional procedure performed in liver cirrhosis complicated with portal hypertension to improve the low platelet count. This technique represents an efficient alternative to splenectomy, which has major drawbacks and is associated with a high morbidity. We report a series of patients with liver cirrhosis and portal hypertension who presented with severe thrombocytopenia and were treated with partial splenic embolization eventually having a favourable outcome.

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Objective: The aim of the study was to assess the particularities of very elderly patients with high blood pressure and atrial fibrillation, which associate other comorbidities. Design and method: We performed a retrospective study on a group of 97 very elderly patients over 90 years with hypertension, admitted to an emergency hospital in the last 5 years. Results: The average age was 92 years. 67% of the patients were female and 33% male. 40.21% of these patients also had atrial fibrillation. In the subgroup of patients with hypertension and atrial fibrillation, the gender distribution was: 64.10% Female and 35.90% Male. The minimum age was 90 years, the maximum age 98 years. 5.13% Of them came from an old foster care and 41% were immobile. 17.95% Had bed sores. The mean systolic blood pressure that was detected at admission was 135 mmhg and the mean diastolic blood pressure was 75 mmhg. 84.62% of patients were diagnosed with chronic heart failure (33.34% Nyha class ii, 36.36% Nyha class iii and 30.3% Nyha class iv). An echocardiography was performed in 30.77% Of cases and 25% of patients had a preserved ejection fraction. Changes in the electrocardiogram encountered were: right branch block in 12.82% of patients, left branch block in 10.26%, Premature ventricular contractions in 5.13%, And atrial fibrillation with rapid ventricular response in 28.21%. Other co-morbidities: 51.28% Presented with respiratory failure, 15.38% Had copd, 20.51% Required noninvasive ventilation and at the same number of patients an oxygen concentrator was recommended at discharge. 17.95% Of patients had type 2 diabetes mellitus, 20.51% Had a history of stroke and 94.87% Had an altered estimated glomerular filtration rate (based on mdrd formula). Conclusions: The management of very elderly patients is a challenge for the clinician. It is necessary to pay greater attention to the interactions between drugs and the type of administration. They are very fragile patients, with many comorbidities that can lead to complications.

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