title: Evaluation of the Amplatzer vascular plug for proximal splenic artery embolization.
abstract: OBJECTIVE
  Proximal splenic artery embolization is performed for splenic salvage in the setting of trauma or before splenectomy in patients with splenomegaly. Typically, this has been done with the use of metallic coils, but precise placement of the first deposited coil may be limited. The Amplatzer vascular plug (AVP) may be used to accomplish precise proximal splenic artery embolization.
  
  
  METHODS
  Fourteen patients had proximal splenic artery embolization performed with the AVP. Thirteen were performed to allow splenic salvage after blunt trauma and one was performed before splenectomy for massive splenomegaly. Devices ranging in diameter from 8 to 12 mm were placed through 5-F or 6-F guiding catheters. Desired AVP location was distal to the dorsal pancreatic artery and proximal to the most peripheral pancreatica magna branch. Test injections of contrast agent were performed after approximately 5 minutes and then at 3-5-minute intervals until occlusion was seen. If this was not noted by 15 minutes, an adjunctive closure method was chosen. Computed tomography (CT) follow-up was performed in all patients.
  
  
  RESULTS
  Device placement in the desired location was successful in all cases, with device repositioning required in two. Occlusion took an average of approximately 10 minutes. Additional coils placed in three patients could all be packed into a tight configuration. A second AVP was placed in one patient. There were no complications of the procedures. Follow-up CT images showed no evidence of migration or recanalization of any of the devices. Minimal artifact was noted from the AVP on CT.
  
  
  CONCLUSIONS
  In this preliminary series, use of the AVP allowed for precise proximal splenic artery embolization.
authors.affiliation: Division of Interventional Radiology, Department of Radiology, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA. dwidlus@umm.edu
authors.forename: David M
authors.initials: DM
authors.lastname: Widlus
authors.forename: Fred M
authors.initials: FM
authors.lastname: Moeslein
authors.forename: Howard M
authors.initials: HM
authors.lastname: Richard
mesh_terms: D000293:Adolescent; D000328:Adult; D000792:Angiography; D001807:Blood Vessel Prosthesis; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013157:Splenic Artery; D013163:Splenomegaly / Q000000981:diagnostic imaging / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome