Long-Term Immune Function Following Splenic Artery Embolisation for Blunt Abdominal Trauma

Lukies, Matthew; Kavnoudias, Helen; Zia, Adil; Lee, Robin; Bosco, Julian J.; Joseph, Tim; Clements, Warren

doi:10.1007/s00270-020-02627-x

Cited by 8 publications

(10 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Splenic injury is the most common intra-abdominal injury following blunt abdominal trauma [6]. In haemodynamically stable patients with blunt splenic injury, (NOM) has become the standard of care as it is cost-effective and has been shown to preserve longterm splenic immune function [7,8]. In intermediate to high-grade splenic injuries (Grade III-V), embolization has been shown to increase the success rates of NOM [9].…”

Section: Discussionmentioning

confidence: 99%

“…secondary splenectomy; however distal embolization carries a higher risk of minor complications not requiring splenectomy due to the rate of infarction distal to the site of embolization [12]. In a recent study, it was shown that there is no significant difference in splenic immunological function between the two approaches and that long-term immune function can also be preserved in this cohort [8,13].…”

Section: Learning Pointsmentioning

confidence: 93%

See 1 more Smart Citation

Delayed Splenic Abscess Post Splenic Arterial Embolization for Trauma in a Patient with Previous Sleeve Gastrectomy

Thomas¹,

Charles²,

Warren³

et al. 2021

Clin Med Rev Case Rep

View full text Add to dashboard Cite

Fourteen weeks later (98 days), the patient represented with five days' history of sharp left flank pain radiating to the left shoulder and back. In the emergency department, she was febrile at 38.1 °C and tachycardic at 105 beats per minute. Inflammatory markers were elevated with white cell count (WCC) of 14.7 × 10 9 /L and C-Reactive Protein (CRP) of 190 mg/L. Repeat computerised tomography scan revealed a large area of devascularised splenic tissue with a peripherally enhancing collection measuring 4 cm and surrounding

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Learning Pointsmentioning

confidence: 93%

Delayed Splenic Abscess Post Splenic Arterial Embolization for Trauma in a Patient with Previous Sleeve Gastrectomy

Thomas¹,

Charles²,

Warren³

et al. 2021

Clin Med Rev Case Rep

View full text Add to dashboard Cite

show abstract

“…The effect of these results is to further sub stratify this patient group beyond the AAST classification where it is possible that occult vascular injuries are the reason for those who do subsequently re-bleed with a grade III injury. In addition, it can be argued that the low rate of complications in the AAST III cohort of 0% and preservation of splenic function (Lukies et al 2020;Schimmer et al 2016) further warrants such consideration for treatment. The presence of vascular injury in the grade III cohort from this study also supports the recent changes to AAST to acknowledge the importance of vascular injury in their classification system.…”

Section: Discussionmentioning

confidence: 99%

“…Splenic salvage for hemodynamically stable trauma patients is now standard of care (Patil et al 2020). Splenic embolization is also relatively unique, in that it can offer both immediate hemodynamic control as well as preserving splenic function (Lukies et al 2020;Aiolfi et al 2017).…”

Section: Introductionmentioning

confidence: 99%

SPLEnic salvage and complications after splenic artery EmbolizatioN for blunt abdomINal trauma: the SPLEEN-IN study

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background As an adjunct to non-operative management, splenic artery embolization (SAE) has been increasingly utilized throughout the world and is now the standard of care for hemodynamically stable patients. This study aimed to retrospectively assess the rate of splenic salvage and complications after SAE for blunt trauma at a level 1 trauma center using the 2018 update to the AAST criteria, and further sub-stratify the role of angiography in AAST grade III injuries with significant hemoperitoneum. All patients between 1 January 2009 and 1 January 2019 who underwent blunt trauma and proceeded to embolization were included. Data was collected concerning initial injury grade, location of embolization, type of embolic material used, complications, and need for subsequent splenectomy. Technical success was defined as successful angiographic occlusion of the target artery at the conclusion of embolization. Clinical success was defined as splenic salvage at discharge. Vascular lesions were characterized including those with active bleeding, pseudoaneurysm, and arterio-venous fistula. Results Two hundred thirty-two patients were included in the study. Treatments were performed at a median of 0 days (range 0–28 days) and the median AAST grade was IV (range III-V). Technical success was achieved in all patients. There were 13 complications (5.6%) consisting of re-bleed (9, 3.9%), infarction (3, 1.3%), and access site haematoma (1, 0.43%). Clinical success was achieved in 97% of patients with 7 patients requiring splenectomy after SAE (3.0%) at a median time of 4 days (range 0–17 days). Angiography in patients with grade III injuries identified 18 occult vascular injuries not identified at initial CT (p < 0.0001). Conclusions The SPLEEN-IN study shows that treatment of intermediate-high grade blunt force traumatic splenic injuries using SAE resulted in a low rate of complication and splenic salvage in 97% of patients, providing a safe and effective treatment in stable patients. In addition, angiography of grade III injuries identified occult vascular lesions and may warrant treatment of select patients in this cohort. Level of evidence Level 3.

show abstract

“…Current guidelines and research focus on SAE being offered to stable patients with low grade splenic injuries as an adjunct to non-operative management (NOM) [4] [5] [6].…”

Section: Introductionmentioning

confidence: 99%

The Role of Interventional Radiology in Splenic Trauma

Somanathan¹

2022

IJCM

View full text Add to dashboard Cite

The purpose of this case report is to discuss the different treatment options available in splenic trauma patients by following the story of Mr. H. I will focus particularly on the role of splenic arterial embolisation (SAE)-an interventional radiological procedure-and how it weighs up against its surgical counterparts. In order to give a balanced view this case report includes a literature review around splenic artery embolisation. This report concludes that when managing splenic trauma, interventional radiology (IR) is a useful tool particularly when used in conjunction with surgery. The future of this field needs to allow SAE to become a stand-alone therapy. Furthermore, research needs to investigate which cohorts of patients are best suited to which intervention such that we can capitalise on the advantages of each intervention for the benefit of all.

show abstract

Long-Term Immune Function Following Splenic Artery Embolisation for Blunt Abdominal Trauma

Cited by 8 publications

References 5 publications

Delayed Splenic Abscess Post Splenic Arterial Embolization for Trauma in a Patient with Previous Sleeve Gastrectomy

Delayed Splenic Abscess Post Splenic Arterial Embolization for Trauma in a Patient with Previous Sleeve Gastrectomy

SPLEnic salvage and complications after splenic artery EmbolizatioN for blunt abdomINal trauma: the SPLEEN-IN study

The Role of Interventional Radiology in Splenic Trauma

Contact Info

Product

Resources

About