• Injury · Oct 2024

    Review

    Complications and failure rate of splenic artery angioembolization following blunt splenic trauma: A systematic review.

    • Zubaidah Alomar, Yousif Alomar, Ismail Mahmood, Ali Alomar, Ayman El-Menyar, Mohammad Asim, Sandro Rizoli, and Hassan Al-Thani.
    • Jordan University of Science and Technology (Student), Jordan.
    • Injury. 2024 Oct 1; 55 (10): 111753111753.

    BackgroundOver recent decades, splenic angioembolization (SAE) as an adjunct to non-operative management (NOM) has emerged as a prominent intervention for patients with blunt splenic injuries (BSI). SAE improves patient outcomes, salvages the spleen, and averts complications associated with splenectomy. This systematic review aimed to evaluate the failure rate and complications related to SAE in patients with BSI.MethodsA systematic literature search (PubMed, SCOPUS, and Cochrane Library) focused on studies detailing splenic angioembolization in blunt trauma cases. Articles that fulfilled the predetermined inclusion criteria were included. This review examined the indications, outcomes, failure rate, and complications of SAE.ResultsAmong 599 identified articles, 33 met the inclusion criteria. These comprised 29 retrospective studies, three prospective studies, and one randomized control trial. The analysis encompassed 25,521 patients admitted with BSI and 3,835 patients who underwent SAE. The overall failure rate of SAE was 5.3 %. Major complications predominantly were rebleeding (4.8 %), infarction (4.6 %), and abscess formation (4 %). Minor complications were fever (18.4 %), pleural effusion (13.1 %), and coil migration (3.9 %). Other complications included splenic atrophy, splenic cyst, hematoma, and access site complications such as splenic/femoral dissection. Overall, post embolization mortality was 0.08 %.ConclusionSAE is a valuable adjunct in managing BSI, with a low failure rate. However, this treatment modality is not without the risk of potentially serious complications.Copyright © 2024 Elsevier Ltd. All rights reserved.

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