Platelet Changes Following Partial Splenic Artery Embolization in Cirrhotic Patients with Hypersplenism

Abstract
Background: Hypersplenism is a common complication of cirrhosis, leading to thrombocytopenia and leukopenia. Partial splenic artery embolization (PSE) has been introduced as an effective alternative to surgical splenectomy, effectively increasing hematologic indices particularly the platelets and lowering risk of bleeding.
Aim of Study: To investigate the effect of partial splenic Artery embolization (PSE) on platelet Count in cirrhotic patients with Hypersplenism.
Patients and Methods: Fifteen patients with chronic liver disease were included. All patients had Cirrhosis with hyper-splenism and all patients underwent PSE in one session with follow-up after one month.
Results: The mean age of the selected patients was about 49 years old.
All patients showed significant increase in the platelet count after one session and remained at appropriate levels during the follow-up period.
Postembolization syndrome was the most common com-plication and noted in in 14 patients (93.3%). Ascites reported in 3 patients (20%). Portal vein thrombosis reported in 2 patient (13.3%) left sided pleural effusion developed in 1 patient (6.6%). No pancreatitis or splenic abscess reported. None of the patients developed septic shock. No post procedure mortality occurred.
Conclusion: Partial splenic artery embolization is not without risks, but proven to be effective treatment for throm-bocytopenia in cirrhotic patients with hypersplenism. It is performed under local anesthesia, thus is suitable in surgically unfit patients. It achieves improvement of hematological status with less complications as well as preservation splenic role in immunity.