title: Splenic Arterial Embolization in the Treatment of Severe Portal Hypertension Due to Pancreatic Diseases: The Primary Experience in 14 Patients.
abstract: OBJECTIVE
  This retrospective study reports our experience using splenic arterial particle embolization and coil embolization for the treatment of sinistral portal hypertension (SPH) in patients with and without gastric bleeding.
  
  
  METHODS
  From August 2009 to May 2012, 14 patients with SPH due to pancreatic disease were diagnosed and treated with splenic arterial embolization. Two different embolization strategies were applied; either combined distal splenic bed particle embolization and proximal splenic artery coil embolization in the same procedure for acute hemorrhage (1-step) or interval staged distal embolization and proximal embolization in the stable patient (2-step). The patients were clinically followed.
  
  
  RESULTS
  In 14 patients, splenic arterial embolization was successful. The one-step method was performed in three patients suffering from massive gastric bleeding, and the bleeding was relieved after embolization. The two-step method was used in 11 patients, who had chronic gastric variceal bleeding or gastric varices only. The gastric varices disappeared in the enhanced CT scan and the patients had no gastric bleeding during follow-up.
  
  
  CONCLUSIONS
  Splenic arterial embolization, particularly the two-step method, proved feasible and effective for the treatment of SPH patients with gastric varices or gastric variceal bleeding.
authors: Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan, 430022, People's Republic of China. wqtjmu@gmail.com.
authors: Qi
authors: Q
authors: Wang
authors: Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan, 430022, People's Republic of China. herrxiong@126.com.
authors: Bin
authors: B
authors: Xiong
authors: Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan, 430022, People's Republic of China. hqzcsxh@sina.com.
authors: ChuanSheng
authors: C
authors: Zheng
authors: Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan, 430022, People's Republic of China. whliangming@163.com.
authors: Ming
authors: M
authors: Liang
authors: Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan, 430022, People's Republic of China. cjr.hanping@vip.163.com.
authors: Ping
authors: P
authors: Han
mesh_terms: D000328:Adult; D004621:Embolization, Therapeutic / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000628:therapy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000150:complications*; D012189:Retrospective Studies; D013157:Splenic Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D013162:Splenic Vein / Q000473:pathology; D055815:Young Adult
keywords: Arterial intervention; Clinical practice; Interventional oncology; Venous intervention