• Naohiro Okada, Hidenori Mitani, Takuya Mori, Masatomo Ueda, Keigo Chosa, Wataru Fukumoto, Kazuki Urata, Ryoichiro Hata, Hajime Okazaki, Masashi Hieda, and Kazuo Awai.
• Department of Diagnostic Radiology, Hiroshima Prefectural Hospital, 1-5-54, Ujinakanda, Minami-ku, Hiroshima, 734-8530, Japan; Hiroshima City North Medical Center Asa Citizens Hospital, 1-2-1, Kameyamaminami, Asakita-ku, Hiroshima, 731-0293, Japan.
• Injury. 2024 Aug 3: 111768111768.

PurposeWe described clinical outcomes for patients with blunt splenic injuries treated with transarterial embolization (TAE) based on their hemodynamic status.Materials And MethodsThis is a retrospective two-center study of adult patients with splenic injuries who underwent emergency TAE between January 2011 and December 2022. Patients were divided into two groups; hemodynamically unstable (HDU) and hemodynamically stable (HDS) patients. HDU patients were defined as transient- or non-responders to fluid resuscitation and HDS as responders. When immediate laparotomy was not possible for HDU patients, angiography and embolization were performed. The primary outcome was the survival discharge rate. Rebleeding and splenectomy rate was also investigated.ResultsOf 38 patients underwent emergency TAE for splenic trauma, 17 were HDU patients and 21 were HDS patients. The survival discharge rate was 88.2 % (15/17) in the HDU- and 100 % in HDS patients (p = 0.193). Rebleeding rate was 23.5 % (4/17) in HDU- and 5.0 % (1/21) in HDS patients (p = 0.15). Splenectomy was required for one HDU patient (5.9 %) for rebleeding.ConclusionThe survival discharge rate of TAE for splenic trauma in HDU patients was acceptable with a low rate of splenectomy. Further comparative studies of TAE versus operative management in HDU patients are needed to prove the usefulness of TAE.Copyright © 2024 Elsevier Ltd. All rights reserved.

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