Splenic embolization

Splenic (artery) embolization is an endovascular technique for treatment of splenic and splenic artery pathology as an alternative to splenic artery ligation or splenectomy. It often results in successfully treating the underlying pathology, while maintaining at least partial splenic function.

Indications

• traumatic splenic injury, particularly AAST grade III-V in haemodynamically stable patients
• hypersplenism
• splenic malignancy
• splenic steal syndrome
• splenic artery aneurysm or pseudoaneurysm

Technique

There are a multitude of techniques including:

• partial or complete embolization
• proximal or distal embolization
• coil, particle or glue embolization

Complications

• left pleural effusion and atelectasis (20-50%) 
• splenic infarct (~3%)
• splenic abscess (~2%)

Long term immune function

In contrast to patients who undergo splenectomy, patients who undergo splenic artery embolization are demonstrated to have preserved immune function at long term follow up. This evidence is supported by research studies that report the lack of circulating Howell jolly bodies on follow up.