Abstract / Summary
Abstract Background: To evaluate whether the anatomical level of main truncal splenic artery embolization, classified according to pancreatic arterial landmarks, is associated with post-procedural splenic infarction. This retrospective single-center study included 28 adult patients who underwent main truncal splenic artery embolization between May 2018 and April 2023 for traumatic (n = 13, high-grade blunt splenic injury) or non-traumatic vascular conditions (n = 15), with post-procedural imaging follow-up. Embolization sites were classified into three anatomical areas: Area 1 (proximal to the dorsal pancreatic artery), Area 2 (between the dorsal and greater pancreatic arteries), and Area 3 (distal to the greater pancreatic artery). Embolic materials included coils (75%), vascular plugs (18%), and liquid embolic agents (32%). Outcomes included technical success, clinical failure, and post-procedural splenic infarction.
Results: Technical success was achieved in all procedures, with no rebleeding, splenectomy, or splenic abscess. New or enlarged splenic infarction occurred in 10 of 28 patients (36%), including >50% splenic involvement in 3 (11%). New infarction occurred in 0% (0/3) of Area 1, 17% (1/6) of Area 2, and 32% (6/19) of Area 3 embolizations, without a statistically significant difference between groups (Fisher's exact test, p = 0.529).
Conclusions: Main truncal splenic artery embolization demonstrated excellent technical success and clinical safety across diverse indications. Although not statistically significant, new splenic infarction occurred numerically more often following embolization distal to the greater pancreatic artery. These preliminary findings support prospective validation of this anatomical classification in larger multicenter studies.