Partial Splenic Embolization (PSE) in the Management of Thrombocytopenia Due to Hypersplenism.

Abstract

Introduction: Hypersplenism with resultant thrombocytopenia is a common complication of chronic liver disease. Recent studies suggest the safety advantages of PSE over the definitive treatment, splenectomy. This review investigates the efficacy of PSE by evaluating its impact on platelet and WBC counts. Method(s): Tanzanian patients with thrombocytopenia due to hypersplenism underwent PSE at Muhimbili National Hospital from March 2019 to June 2021. Splenic volumes were evaluated preprocedure using CT. Particle embolization of the inferior distal branches of the splenic artery was performed using previously described techniques. The embolization area was measured 1 month post procedure with CT. Platelet and WBC counts were evaluated preprocedure and 2 weeks, 1 month, and 6 months post procedure. Result(s): A total of 12 patients were treated with PSE. The average emblazed area was 66.7%. There is a significant increase in platelet and WBC counts at all follow-up intervals (p < 0.05). The emblazed area and the change in platelet or WBC count are not correlated. One patient developed a splenic abscess. Conclusion(s): PSE is a technically feasible, effective, and safe alternative to splenectomy in the management of hypersplenism. This study serves as a foundation for wider adoption in other low-resource settings.