title: Blunt splenic injury: outcomes of proximal versus distal and combined splenic artery embolization.
abstract: OBJECTIVE
  To assess clinical outcomes of blunt splenic injuries (BSI) managed with proximal versus distal versus combined splenic artery embolization (SAE).
  
  
  METHODS
  All consecutive patients with BSI admitted to our trauma centre from 2005 to 2010 and managed with SAE were reviewed. Outcomes were compared between proximal (P), distal (D) or combined (C) embolization. We focused on embolization failure (splenectomy), every adverse events occurring during follow up and material used for embolization.
  
  
  RESULTS
  Fifty patients were reviewed (P n = 18, 36%; D n = 22, 44%; C n = 8, 16%). Mean injury severity score was 20. The technical success rate was 98%. Four patients required splenectomy (P n = 1, D n = 3, C n = 0). Clinical success rate for haemostasis was 92% (4 re-bleeds: P n = 2, D n = 2, C n = 0). Outcomes were not statistically different between the materials used. Adverse events occurred in 65% of the patients during follow up. Four percent of the patients developed major complications and 56% developed minor complications attributable to embolization. There was no significant difference between the 3 groups.
  
  
  CONCLUSIONS
  SAE had an excellent success rate with adverse events occurring in 65% of the patients and no significant differences found between the embolization techniques used. Proximal preventive embolization appears to protect in high-grade traumatic injuries.
authors.affiliation: University Radiology and Medical Imaging Clinic CURIM, Grenoble University Hospital, BP 217, 38043 Grenoble cedex 09, France. Electronic address: Jfrandon2@chu-grenoble.fr.
authors.forename: J
authors.initials: J
authors.lastname: Frandon
authors.affiliation: University Radiology and Medical Imaging Clinic CURIM, Grenoble University Hospital, BP 217, 38043 Grenoble cedex 09, France.
authors.forename: M
authors.initials: M
authors.lastname: Rodière
authors.affiliation: University Gastrointestinal and Emergencies Clinic, Grenoble University Hospital, BP 217, 38043 Grenoble cedex 09, France.
authors.forename: C
authors.initials: C
authors.lastname: Arvieux
authors.affiliation: University Radiology and Medical Imaging Clinic CURIM, Grenoble University Hospital, BP 217, 38043 Grenoble cedex 09, France.
authors.forename: M
authors.initials: M
authors.lastname: Michoud
authors.affiliation: University Radiology and Medical Imaging Clinic CURIM, Grenoble University Hospital, BP 217, 38043 Grenoble cedex 09, France.
authors.forename: A
authors.initials: A
authors.lastname: Vendrell
authors.affiliation: Anaesthesia and Surgical Intensive Care Clinic, Grenoble University Hospital, BP 217, 38043 Grenoble cedex 09, France.
authors.forename: C
authors.initials: C
authors.lastname: Broux
authors.affiliation: University Radiology and Medical Imaging Clinic CURIM, Grenoble University Hospital, BP 217, 38043 Grenoble cedex 09, France.
authors.forename: C
authors.initials: C
authors.lastname: Sengel
authors.affiliation: University Radiology and Medical Imaging Clinic CURIM, Grenoble University Hospital, BP 217, 38043 Grenoble cedex 09, France.
authors.forename: I
authors.initials: I
authors.lastname: Bricault
authors.affiliation: University Radiology and Medical Imaging Clinic CURIM, Grenoble University Hospital, BP 217, 38043 Grenoble cedex 09, France.
authors.forename: G
authors.initials: G
authors.lastname: Ferretti
authors.affiliation: University Radiology and Medical Imaging Clinic CURIM, Grenoble University Hospital, BP 217, 38043 Grenoble cedex 09, France.
authors.forename: F
authors.initials: F
authors.lastname: Thony
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography; D002648:Child; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013156:Splenectomy; D013157:Splenic Artery; D013161:Splenic Rupture / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000628:therapy*; D055815:Young Adult
keywords: Blunt splenic injury; Embolization; Splenic artery