title: Embolization therapy for traumatic splenic lacerations.
abstract: OBJECTIVE
  This study was designed to evaluate the clinical success, complications, and transfusion requirements based on the location of and agents used for splenic artery embolization in patients with splenic trauma.
  
  
  METHODS
  A retrospective study was performed of patients with splenic trauma who underwent angiography and embolization from September 2000 to January 2010 at a level I trauma center. Electronic medical records were reviewed for demographics, imaging data, technical aspects of the procedure, and clinical outcomes.
  
  
  RESULTS
  Fifty patients were identified (34 men and 16 women), with an average age of 48 (range, 16-80) years. Extravasation was seen on initial angiography in 27 (54%) and was absent in 23 (46%). All 27 patients with extravasation were embolized, and 18 of 23 (78.2%) without extravasation were embolized empirically. Primary clinical success was similar (>75%) across all embolization locations, embolic agents, and grades of laceration treated. Of 45 patients treated, 9 patients (20%) were embolized in the main splenic artery, 34 (75.6%) in the splenic hilum, and 2 (4.4%) were embolized in both locations. Partial splenic infarctions developed in 47.3% treated in the splenic hilum compared with 12.5% treated in the main splenic artery. There were four (8.9%) mortalities: two occurred in patients with multiple critical injuries and two from nonbleeding etiologies.
  
  
  CONCLUSIONS
  Embolization of traumatic splenic artery injuries is safe and effective, regardless of the location of treatment. Embolization in splenic hilar branches may have a higher incidence of infarction. The grade of laceration and agents used for embolotherapy did not impact the outcomes.
authors.affiliation: Division of Vascular and Interventional Radiology, Department of Radiology, University of Virginia Health System, Charlottesville, 22908-0170, USA.
authors.forename: Niloy
authors.initials: N
authors.lastname: Dasgupta
authors.forename: Alan H
authors.initials: AH
authors.lastname: Matsumoto
authors.forename: Bulent
authors.initials: B
authors.lastname: Arslan
authors.forename: Ulku C
authors.initials: UC
authors.lastname: Turba
authors.forename: Saher
authors.initials: S
authors.lastname: Sabri
authors.forename: John F
authors.initials: JF
authors.lastname: Angle
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001803:Blood Transfusion / Q000706:statistics & numerical data; D004621:Embolization, Therapeutic / Q000379:methods*; D005119:Extravasation of Diagnostic and Therapeutic Materials; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013154:Spleen / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000293:injuries*; D013157:Splenic Artery / Q000000981:diagnostic imaging / Q000293:injuries; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome