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Zenodo
By Danny Manuel Vera Alay, Vanessa Lissette Yanzaguano Morquecho, Raúl Ibarra Burbano and 2 others.
High-grade blunt splenic injury in adults requires balancing hemorrhage control, functional splenic preservation and availability of endovascular resources.
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To synthesize evidence on prophylactic splenic angioembolization versus initial surveillance in stable or stabilizable adults with high-grade blunt splenic injury, considering nonoperative management failure, splenectomy, secondary intervention, adverse events and clinical applicability.
A systematic review without meta-analysis, with narrative synthesis, was conducted according to PRISMA 2020. The search was performed on December 30, 2025, in PubMed/MEDLINE, Embase, Scopus, Web of Science, Cochrane Library and LILACS. Studies published from January 1, 2020, to the search date, in English or Spanish, were included if they evaluated adults with grade III-V blunt splenic injury treated with prophylactic angioembolization or initial surveillance. Study selection and data extraction were performed by two reviewers, with discrepancies resolved by consensus or a third reviewer.
Sixteen articles were included in the qualitative synthesis. One directly comparative randomized clinical trial and observational studies provided information on splenic salvage, treatment failure, secondary embolization, delayed splenectomy, adverse events and institutional applicability. Studies showed heterogeneity in definitions of high-grade injury, high-risk criteria, endovascular technique, follow-up and outcome measurement.
Prophylactic angioembolization may be useful in higher-risk subgroups but should not be applied indiscriminately. Decisions should be individualized according to anatomical severity, vascular findings, physiological risk and institutional availability.
Published in Zenodo (CERN European Organization for Nuclear Research). The abstract is shown as published and remains the work of its authors; read the full article at the source.
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