Long-term results of partial splenic artery embolization as supplemental treatment for portal-systemic encephalopathy.
OBJECTIVE
To present long-term results of angiographic partial splenic artery embolization (PSE) as a supplemental treatment of portal-systemic encephalopathy.


METHODS
Twenty-five patients with portal-systemic encephalopathy were divided into two groups: 14 patients underwent transportal obliteration and/or balloon-occluded retrograde transvenous obliteration (BRTO) of portal-systemic shunts (PSS), followed by PSE (PSE(+) group), and 11 patients underwent only transportal obliteration and/or BRTO of PSS (PSE(-) group).


RESULTS
Portal venous pressures pretreatment was similar to posttreatment in the PSE(+) group, but lower than posttreatment in the PSE(-) group. Serum ammonia levels were higher at pretreatment than at 1 wk posttreatment in both groups, but the levels in the two groups were similar at pretreatment, 1 wk, 3 months, 3 yr, 4 yr, and 5 yr posttreatment. However, serum ammonia levels were lower in the PSE(+) group than in the PSE(-) group 6 months, 9 months, 1 yr, and 2 yr posttreatment. Grades of encephalopathy were higher at pretreatment than at 1 wk posttreatment in both groups, but the levels in the two groups were similar at pretreatment, 1 wk, 2 yr, 3 yr, 4 yr, and 5 yr posttreatment. However, grades of encephalopathy were lower in the PSE(+) group than in the PSE(-) group 3 months, 6 months, 9 months, and 1 yr posttreatment.


CONCLUSIONS
Obliteration of PSS followed by PSE benefit patients with portal-systemic encephalopathy.
Yoshida
Hiroshi
H
First Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
Mamada
Yasuhiro
Y
Taniai
Nobuhiko
N
Yamamoto
Kazuhito
K
Kaneko
Masahiro
M
Kawano
Youichi
Y
Mizuguchi
Yoshiaki
Y
Kumazaki
Tatsuo
T
Tajiri
Takashi
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000641:Ammonia / Q000097:blood; D021721:Balloon Occlusion; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006501:Hepatic Encephalopathy / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017082:Portal Pressure / Q000502:physiology; D013157:Splenic Artery / Q000601:surgery*; D016896:Treatment Outcome
D000641:Ammonia