Predictive factors of platelet increase and complications after percutaneous trans-arterial partial splenic embolization for hypersplenism in chronic liver disease patients

To identify predictive factors for platelets normalization and major complications associated with partial splenic embolization (PSE) in patients with chronic liver disease and hypersplenism. A prospective study included 30 patients were subjected to pre-embolization abdominal US and laboratory test...

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Published in:	Egyptian journal of radiology and nuclear medicine Vol. 48; no. 2; pp. 393 - 401
Main Authors:	Hussein, Walid M., Ahmed, Ahmed Tohamy, El-Nesr, Magdy M., Amer, Talal A., Habba, Mohammad R.
Format:	Journal Article
Language:	English
Published:	Elsevier B.V 01-06-2017 SpringerOpen
Subjects:	Hypersplenism Infarction rate Partial Splenic Embolization (PSE) Platelet count increase Polyvinyl alcohol (PVA) Polyvinyl alcohol (PVA) Infarction rate Hypersplenism Platelet count increase Partial Splenic Embolization (PSE)
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Summary:	To identify predictive factors for platelets normalization and major complications associated with partial splenic embolization (PSE) in patients with chronic liver disease and hypersplenism. A prospective study included 30 patients were subjected to pre-embolization abdominal US and laboratory testing (WBC, Hemoglobin, Platelet Count, T. Bilirubin, AST, ALT, S. Albumin). PSE were done by super-selective catheterization of splenic artery and embolization by Polyvinyl alcohol with targeted therapeutic splenic infarction rate (>30% to <70–80%). CECT was performed before and 2weeks after to assess complications (post embolization syndrome, ascites, peritonitis,pleural effusion, and splenic abscess) and infarction size. CBC, liver function tests was done after 2weeks, 6months. Platelet count done on the next day after the embolization. Multiple logistic regression analysis showed that the infarction rate could be used as a predictor for platelets normalization (p value=0.005, OR=1.493). ROC curve showed that infarction rate above 76% had 100% specificity for platelets normalization after 6months; infarction rate above 67% had 92.3% specificity. S. Albumin (2.7–3.2mg/L), Child Score >8 remained significant predictors for major complication (p=0.035). Platelet count normalization could be achieved by increasing infraction rate to 67–76%. Child Score and serum albumin are the predictive factor for complications.
ISSN:	0378-603X
DOI:	10.1016/j.ejrnm.2017.01.010