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Children
RFS Journal Primer
Quick Summary
BOTTOM LINE
Partial splenic embolization (PSE) is a safe and effective procedure for improving hematologic
indices in children with severe hypersplenism associated with portal hypertension
MAJOR POINTS
PSE is a reasonable alternative in patients with severe hypersplenism as there is significant risk of
sepsis after surgical splenectomy
Long-term efficacy (platelet counts remaining normal throughout follow-up) was shown in 70% of
survivors
CRITICISM
Study design
Single Center Retrospective Review
1984-2001
INCLUSION CRITERIA
EXCLUSION CRITERIA
Purpose
Intervention
Gelfoam cut into 2 x 2 mm pieces and suspended in antibiotic solution of penicillin G and
gentamycin immediately before intra-arterial injection
Femoral or axillary artery approach was utilized for splenic artery catheterization
Solution of antibiotics used for injection of embolic particles as opposed to contrast medium
Percentage of embolized volume was precisely evaluated using technetium 99m Sn colloid
splenic scintigram
Outcome
Hematologic indices improved in all 36 patients after PSE, and its long-term efficacy was
shwon in 70% of survivors
Percent of embolized splenic volume was not statistically significant between patients with
and without recurrence of thrombocytopenia (68% vs 71%)
Platelet counts before PSE in patients with and without recurrent thrombocytopenia were not
signiciant (61,200 vs 62,600, respectively)
The peak value of platelet counts of patients without recurrence of thrombocytopenia was
significantly greater than those with recurrence (453,100 vs 275,600, P<.01)
Recurrence
No recurrence
11
25
19
Dead
Liver tx
Not significant
68 +/- 13
71 +/- 14
Not significant
61.2+/- 2.1
Not significant
Peak Plt
<.01
Final Plt
<.001
# Cases
P value
Outcome
Plt pre-PSE
Not significant
Credits
SUMMARY BY:
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