title: Proximal Versus Distal Splenic Artery Embolisation for Blunt Splenic Trauma: What is the Impact on Splenic Immune Function?
abstract: OBJECTIVE
  To compare the impact of proximal or distal splenic artery embolisation versus that of splenectomy on splenic immune function as measured by IgM memory B cell levels.
  
  
  METHODS
  Patients with splenic trauma who were treated by splenic artery embolisation (SAE) were enrolled. After 6 months splenic volume was assessed by CT, and IgM memory B cells in peripheral blood were measured and compared to a local normal reference population and to a post-splenectomy population.
  
  
  RESULTS
  Of the 71 patients who underwent embolisation, 38 underwent proximal embolisation, 11 underwent distal embolisation, 22 patients were excluded, 1 had both proximal and distal embolisation, 5 did not survive and 16 did not return for evaluation. There was a significant difference between splenectomy and proximal or distal embolisation and a trend towards greater preservation of IgM memory B cell number in those with distal embolisation-a difference that could not be attributed to differences in age, grade of injury or residual splenic volume.
  
  
  CONCLUSIONS
  IgM memory B cell levels are significantly higher in those treated with SAE compared to splenectomy. Our data provide evidence that splenic embolisation should reduce immunological complications of spleen trauma and suggest that distal embolisation may maintain better function.
authors.affiliation: Department of Medical Imaging, The Canberra Hospital, Yamba Drive, Garran, ACT, 2605, Australia. pfoley@doctors.org.uk.
authors.forename: P T
authors.initials: PT
authors.lastname: Foley
authors.affiliation: Radiology Research Unit, Radiology Department, The Alfred Hospital, Commercial Rd, Melbourne, VIC, 3004, Australia. h.kavnoudias@alfred.org.au.
authors.forename: H
authors.initials: H
authors.lastname: Kavnoudias
authors.affiliation: Infectious Diseases Unit, The Alfred Hospital, Commercial Rd, Melbourne, VIC, 3004, Australia. paul.cameron@unimelb.edu.au.|Department of Microbiology and Immunology, Doherty Institute for Infection and Immunity, University of Melbourne, 792 Elizabeth St, Melbourne, VIC, 3000, Australia. paul.cameron@unimelb.edu.au.
authors.forename: P U
authors.initials: PU
authors.lastname: Cameron
authors.affiliation: Radiology Department, Royal Melbourne Hospital, 300 Grattan St, Parkville, VIC, 3050, Australia. caroline.czarnecki@gmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Czarnecki
authors.affiliation: Department of Epidemiology & Preventive Medicine, School of Public Health and Preventive Medicine, Alfred Hospital, Monash University, Commercial Rd, Melbourne, VIC, 3004, Australia. eldho.paul@monash.edu.
authors.forename: E
authors.initials: E
authors.lastname: Paul
authors.affiliation: Melbourne Endovascular, 5 Chesterville Rd, Cheltenham, VIC, 3192, Australia. lyonsey@optusnet.com.au.|Radiology Department, The Alfred Hospital, Commercial Rd, Melbourne, VIC, 3004, Australia. lyonsey@optusnet.com.au.
authors.forename: S M
authors.initials: SM
authors.lastname: Lyon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D013154:Spleen / Q000000981:diagnostic imaging / Q000276:immunology* / Q000293:injuries*; D013156:Splenectomy; D013157:Splenic Artery / Q000000981:diagnostic imaging / Q000276:immunology*; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000276:immunology* / Q000628:therapy*; D055815:Young Adult
keywords: IgM memory B cells; Splenic artery embolisation; Trauma