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    Splenic Artery Embolization for Unstable Patients with Splenic Injury: A Retrospective Cohort Study

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    Authors
    Zoppo, Christopher T
    Valero, Daniel Alvarez
    Murugan, Venkatesh Arumugam
    Pavidapha, Alex
    Flahive, Julie
    Newbury, Alex
    Fallon, Eleanor
    Harman, Aaron
    UMass Chan Affiliations
    Radiology
    T.H. Chan School of Medicine
    Document Type
    Journal Article
    Publication Date
    2022-10-14
    
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    Link to Full Text
    https://doi.org/10.1016/j.jvir.2022.10.014
    Abstract
    Purpose: To compare the outcomes of splenic artery embolization (SAE) for acute splenic injury (ASI) between patients who are hemodynamically stable (HDS) and hemodynamically unstable (HDU). Nonoperative management with SAE has become an accepted practice for patients who are HDS with ASI; however, SAE for the treatment of patients who are HDU with ASI has not been well studied. Materials and methods: A retrospective cohort study was performed, including 52 patients who were HDU and HDS who underwent SAE for ASI at a Level 1 trauma center. HDU was defined as the lowest recorded systolic blood pressure prior to intervention <90 mm Hg. Utilizing the American Association for Surgery of Trauma (AAST) splenic injury scale, AAST Grades 1-3 were defined as low grade, and Grades 4-5 were defined as high grade. The primary outcomes were survival at 30 days and the need for subsequent splenectomy. Results: Seventy-five percent (n = 39) of the patients were HDS, and 25% (n = 13) were HDU. The majority (69%) of patients who were HDU who underwent SAE did not require splenectomy, compared with 95% of patients who were HDS (P = .03). No significant difference in 30-day survival between patients who were HDU and HDS was noted. No major adverse events were recorded. There was no significant difference in 30-day patient survival or the rate of subsequent splenectomy between high-grade and low-grade splenic injuries. Conclusions: In this retrospective cohort study, there was no statistically significant difference in the adverse events or 30-day post-SAE survival rates between patients who were HDS and HDU with ASI. The authors conclude that SAE can be a safe and effective treatment option for patients who are HDU with ASI, including high-grade splenic injury.
    Source
    Zoppo C, Valero DA, Murugan VA, Pavidapha A, Flahive J, Newbury A, Fallon E, Harman A. Splenic Artery Embolization for Unstable Patients with Splenic Injury: A Retrospective Cohort Study. J Vasc Interv Radiol. 2023 Jan;34(1):86-93. doi: 10.1016/j.jvir.2022.10.014. Epub 2022 Oct 14. PMID: 36244633.
    DOI
    10.1016/j.jvir.2022.10.014
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/51577
    PubMed ID
    36244633
    Rights
    Copyright © 2022 SIR. Published by Elsevier Inc. All rights reserved.
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jvir.2022.10.014
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    T.H. Chan School of Medicine Student Publications
    Radiology Publications

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