The impact of splenic artery embolization on the management of splenic trauma: an 8-year review.
BACKGROUND
Splenic artery embolization (SAE) is an adjunct to nonoperative management (NOM) of splenic injuries. We reviewed our experience with SAE to identify its impact on splenic operations.


METHODS
Patients admitted with splenic injuries over an 8-year period were identified and the initial method of management noted (simple observation, SAE, or splenic surgery). The first 4 years (period 1) during which SAE was introduced was compared with the latter 4 years (period 2) when it was used frequently.


RESULTS
There were 304 patients in period 1 and 416 in period 2. NOM was initial management in 59.9% in period 1% and 60.1% in period 2 (P = 1.0) and failure rates were 5.3% versus 2.9%, respectively (P = .12). More SAE procedures were performed in period 2 -- 13.7% versus 4.9% (P < or = .001) -- and there was a reduction in the proportion of splenic operations -- 35.2% versus 26.2% (P <.01).


CONCLUSIONS
SAE is associated with a reduction in splenic operations, although it did not alter the failure rate of NOM.
Ekeh
Akpofure Peter
AP
Department of Surgery, Division of Trauma, Critical Care and Emergency Surgery, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA. peter.ekeh@wright.edu
Izu
Brent
B
Ryan
Mark
M
McCarthy
Mary C
MC
D000007:Abdominal Injuries / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013154:Spleen / Q000293:injuries*; D013157:Splenic Artery; D055815:Young Adult