Partial Splenic Embolization UsingBletilla striataParticles for Hypersplenism in Cirrhosis: A Prospective Study

Abstract

The article evaluates the long-term follow-up results of PSE using Bletilla striata (BS) particles for hypersplenism in cirrhosis, as compared to PSE using gelfoam particles. Fifty-nine patients with cirrhosis-induced hypersplenism were treated with PSE. The patients were randomly assigned into two groups: gelfoam group, which includes 32 patients using gelfoam particles as the embolic material, and BS group, which includes 27 patients using BS particles. The peripheral blood cell counts and parameters for complications associated with PSE were measured during the follow-up. The mean values of leukocyte and thrombocyte, but not hemoglobin, were significantly increased after PSE (p < 0.01) in both groups. The values of leukocyte and thrombocyte during the long-term follow-up were significantly improved in BS group than that in gelfoam group (both p < 0.01). The frequency of bleeding episodes from esophageal varices in both groups was significantly reduced after PSE (both p < 0.01), but the post-PSE bleeding episodes showed no remarkable differences between the two groups (p = 0.084). Post-embolization syndrome consisted mainly of fever, nausea and vomiting, and abdominal pain in the two groups. The incidence of grade II to III abdominal pain in BS group (82.8%, 27/33) was significantly higher than in gelfoam group (57.9%, 33/57) (p = 0.020). The mean survival time was 61.5 ± 9.1 (median 60, 1-157) months in gelfoam group and 63.4 ± 9.9 (median 52, 0-161) months in BS group, which showed no significant difference (p = 0.930). In conclusion, BS particles could be used as the embolic material in PSE. Compared to gelfoam used in PSE, BS can achieve even better efficacy in alleviating hypersplenism. It provides a long-term effect on the hematological parameters, bleeding from esophageal varices and good palliation, and improved clinical status contributing to symptomatic control.

Chemical Constituents, Pharmacologic Properties, and Clinical Applications of Bletilla striata

“…In a study by Liu and coworkers, long-term follow-up of surgical patients revealed a mean survival duration of 61.5 ± 9.1 (median, 60; range, 1–157) months in the control group and 63.4 ± 9.9 (52, 0–161) months in the B. striata group. The spleen thickness of treated patients was reduced compared with that before TACE, and the counts of white blood cells, platelets, and red blood cells returned to within normal ranges (Liu et al, 2011). Therefore, TACE using B. striata as an embolizing agent is a safe and efficacious treatment for patients with hepatic cirrhosis with portal hypertension and secondary hypersplenism.…”

Evidence Based Medicine in Splenic Diseases

“…Материальная эмболизация является эффективным методом, устойчиво повышающим число форменных элементов крови у больных с гиперспленизмом на фоне цирроза печени и снижающим частоту варикозных кровотечений (В) [20]. Эндоваскулярная окклюзия селезеночной артерии при вторичном гиперспленизме на фоне цирроза печени не уступает по эффективности спленэктомии (А) [21][22][23][24][25]. Нерандомизированное проспективное исследование показало преимущество тотальной эмболизации над сегментарной, которое заключалось в улучшении отдаленных результатов (С) [24].…”

A Biomass Based Photonic Crystal Hydrogel Made of Bletilla striata Polysaccharide

“…Pharmacological studies have shown that BSP has various biological activities such as antioxidant [ 37 ], anti-inflammatory [ 38 ], antibacterial [ 39 ], and antitumor [ 40 ]. Due to its good biocompatibility, its own non-toxicity, and easy modification, BSP is widely used in medicine [ 41 ] and cosmetic industries [ 42 ], and has broad application prospects in the fields of pharmaceutical raw materials, biomedical materials, and pharmaceutical excipients.…”