Quantitative splenic embolization possible: application of 8Spheres conformal microspheres in partial splenic embolization (PSE)

Abstract

Background To investigate the safety and efficacy of 8Spheres in partial splenic embolization. To explore the possibility of accurate control of splenic embolic volume by quantifying the number of microspheres used during PSE. Method The data of 179 patients who underwent PSE were collected. The patients were divided into two groups: 300–500 um microsphere group (N = 83) and 500–700 um microsphere group (N = 96). The spleen volume before PSE, infarct volume and infarct rate of the spleen after PSE, changes in peripheral blood cells after PSE, postoperative adverse events and incidence of infection were compared between the two groups. Results 300–500 um group vs 500–700 um group: postoperative spleen volume (cm3): 753.82 ± 325.41 vs 568.65 ± 298.16 (P = 0.008); spleen embolization volume (cm3): 525.93 ± 118.29 vs 630.26 ± 109.71 (P = 0.014); spleen embolization rate: 41.1 ± 12.3% vs 52.4 ± 10.1% (P = 0.021). Leukocytes and platelets were significantly increased after PSE in both groups; leukocyte, 1 month: 4.13 ± 0.91 vs 5.08 ± 1.16 (P = 0.026); 3 months: 4.08 ± 1.25 vs 4.83 ± 0.98 (P = 0.022); platelet, 1 month: 125.6 ± 20.3 vs 138.7 ± 18.4 (P = 0.019); 3 months: 121.8 ± 16.9 vs 134.3 ± 20.1 (P = 0.017). Incidence of abdominal pain after PSE, 72 (86.7%) vs 69 (71.9%), P = 0.027. The incidence of other adverse events and infections after PSE was not statistically different. Conclusion PSE with 8Spheres is safe and effective. The use of 500–700 um microsphere for PSE can make the increase of peripheral blood cells more stable. Each vial of 8Spheres corresponds to a certain volume of splenic embolization, so it is possible to achieve quantitative embolization in PSE.

Simultaneous CSM‐TACE with CalliSpheres® and partial splenic embolization using 8spheres® for hepatocellular carcinoma with hypersplenism: Early prospective multicenter clinical outcome

“…The results of this study also confirmed that a one-time control of the embolization area to 50% can achieve good short-term efficacy. In addition, this study also suggested that 8spheres ® of 500-700 μm may be more suitable for the clinical application of PSE ( 22 ), and it is economical and controllable, thereby further reducing the occurrence of complications.…”

“…The main adverse reactions in this study were post-embolization syndrome, including varying degrees of fever, nausea, vomiting, and epigastric pain ( 22 , 25 , 26 ). After symptomatic treatment, these symptoms gradually relieved and disappeared in a short period of time, although patients in experimental group received CSM-TACE+PSE, and there was no significant difference in the degree and incidence of abdominal pain between the two groups.…”

“…However, the application of DEB-TACE in combination with PSE for HCC combined with hypersplenism has not been reported, and the results of this study showed that the combination of DEB-TACE with PSE was well tolerated by the patients, and the incidence of complications was not significantly increased compared with the control group, indicating that DEB-TACE combined with PSE for the treatment of HCC combined with hypersplenism is completely feasible. Domestic 8spheres ® is a new type of domestic PVA particles, and it has been reported that PSE with 8spheres ® has better safety and good efficacy ( 22 ). Although the results of this study showed that the ORR was above 90% in both groups at 1 month after surgery, also suggested that CSM-TACE simultaneous PSE could improve the median OS of patients with HCC and hypersplenism, and the median OS in the observation group was 2 months loner than that in the control group, which is basically consistent with the (24.47 ± 3.68) months reported by Liu et al.…”

Progress in Endoscopic and Interventional Treatment of Esophagogastric Variceal Bleeding

“…Partial Splenic Artery Embolization. Partial splenic embolization (PSE) is to infarct part of the spleen by embolizing the internal splenic artery and reduce the damage of splenic parenchyma to peripheral blood cells and is mainly used to relieve clinical symptoms of hypersplenism [21]. At the same time, it reduces portal venous pressure due to decreased splenic artery blood flow [22].…”

8Spheres conformal microspheres as embolic agents for symptomatic uterine leiomyoma therapy in uterine artery embolization (UAE): A prospective clinical trial

“…[12] 8Spheres conformal microspheres (Suzhou Hengrui Callisyn Biomedical Technology Co., Ltd, China) were used to embolize benign tumors. [13] As is well known, novel microspheres are not used as embolic agents in UAE. Herein, we designed a prospective single-arm study to further evaluate the efficacy of 8Spheres conformal microspheres in the UAE.…”