Splenic Artery Embolization for Blunt Spleen Injuries Associated With Decreased Mortality, Length of Stay vs Splenectomy

March 30, 2021

By Erika Powers

CLEVELAND, Ohio -- March 29, 2021 -- Compared with splenectomy, treatment of blunt spleen injuries with splenic artery embolization was associated with decreased mortality and length of stay, without an increase in abscess formation, according to a study presented at the Virtual 2021 Annual Meeting of the Society of Interventional Radiology (SIR).

Importantly, splenic artery embolization was as safe and effective in patients aged older than 55 years as it was in younger patients.

“Splenic artery embolization in patients of advanced age is a safe option without increased rates of mortality, abscess formation, or failure,” said Kasey Helmlinger, MD, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee.

The researchers analysed data from 303 patients who were admitted to a level I trauma centre with blunt spleen injury and treated with early splenectomy (n = 213) or initial splenic artery embolization (n = 90) over a 5-year period. The mean patient age was 43.4 years, and most (64%) patients were male.

The overall mean length of stay was 11.3 days, the abscess development rate was 7.1%, and the mortality rate was 13.9%.

Among patients who underwent splenic artery embolization, the mortality rate was 4.4% compared with 17.8% among patients in the splenectomy group -- a difference that was statistically significant (P = .002).

Patients in the splenic artery embolization group stayed in the hospital for a median of 8.38 days compared with 12.6 days for patients in the splenectomy group (P = .04).

Spleen grade and abscess rates did not differ between groups. There were 6 (6.7%) patients that failed splenic artery embolization and required splenectomy.

Of the patients who underwent splenic artery embolization, 27 (30%) were aged 55 years and older. Although the length of stay was longer in older patients (11.48 vs 7.05 days), there were no differences in spleen injury grade, mortality, abscess rate, or failure rates between the older and younger patients.

“There was no difference in outcomes or complications in regards to embolization method,” said Dr. Helmlinger.

[Presentation title: A Comparison of Outcomes in Blunt Spleen Injuries Treated by Splenic Artery Embolization and Splenectomy, a Five-Year Experience. Poster 469]