Severe Complications After Splenic Artery Embolization for Portal Hypertension Due to Hepatic Cirrhosis

Abstract

Background

Splenomegaly/hypersplenism is one of the most common complications of portal hypertension. Splenic artery embolization (SAE) has been increasingly used for treatment of splenomegaly/hypersplenism. However, few studies focused on the severe complications after embolization. In this paper, we reported 16 cases of severe complications after SAE for portal hypertension.

Methods

From February 2011 to January 2019, 16 cirrhotic patients were diagnosed with severe complications after embolization. The clinical symptoms, therapies and prognosis were analyzed.

Results

In these patients, the splenic embolization volume was between 50% and 70%. Among 16 cases, 7 patients were diagnosed with splenic abscess and/or left subphrenic abscess, suffered from the insistent fever, and eventually underwent the surgical therapy; 6 patients with left refractory pleural effusion, suffered from severe chest distress, and underwent repeated thoracocentesis or thoracic closed drainage; 3 patients with thrombosis in portal vein needed oral warfarin therapy.

Conclusion

In cirrhotic patients, the severe complications after SAE are not uncommon after the procedure. It causes more suffering, prolonged hospital stay and more medical cost in these patients. It was debatable whether this technique was an appropriate technique for portal hypertension due to liver cirrhosis, patients contraindicated for the treatment should be carefully identified to avoid the complications.

Keywords:

• portal hypertension
• hypersplenism
• splenic artery embolization
• complication

Acknowledgment

The authors thank MD. Chao-Hong Yu for the linguistic revision.

Abbreviations

HBV, hepatitis B virus; HCV, hepatitis C virus; TIPS, transjugular intrahepatic portosystemic shunt; SAE, splenic artery embolization; SA, splenic abscess; LSA, left subphrenic abscess; LPE, left refractory pleural effusion; TPV, thrombosis in portal vein.

Disclosure

The authors report no conflicts of interest in this work.