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Scandinavian Journal of Gastroenterology Volume 57, 2022 - Issue 1
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Original Article

Two-step complete splenic artery embolization for the management of symptomatic sinistral portal hypertension

Jiacheng Liua Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;b Hubei Province Key Laboratory of Molecular Imaging, Wuhan, ChinaView further author information
,
Jie Menga Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;b Hubei Province Key Laboratory of Molecular Imaging, Wuhan, ChinaView further author information
,
Ming Yangc Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyView further author information
,
Chen Zhoua Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;b Hubei Province Key Laboratory of Molecular Imaging, Wuhan, ChinaView further author information
,
Chongtu Yanga Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;b Hubei Province Key Laboratory of Molecular Imaging, Wuhan, ChinaView further author information
,
Songjiang Huanga Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;b Hubei Province Key Laboratory of Molecular Imaging, Wuhan, ChinaView further author information
,
Qin Shia Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;b Hubei Province Key Laboratory of Molecular Imaging, Wuhan, ChinaView further author information
,
Yingliang Wanga Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;b Hubei Province Key Laboratory of Molecular Imaging, Wuhan, ChinaView further author information
,
Tongqiang Lia Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;b Hubei Province Key Laboratory of Molecular Imaging, Wuhan, ChinaView further author information
,
Yang Chena Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;b Hubei Province Key Laboratory of Molecular Imaging, Wuhan, ChinaView further author information
&
Bin Xionga Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;b Hubei Province Key Laboratory of Molecular Imaging, Wuhan, ChinaCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0002-7795-7041View further author information
ORCID Icon show all
Pages 78-84 | Received 31 Jul 2021, Accepted 16 Sep 2021, Published online: 28 Sep 2021
 
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Abstract

Background

Sinistral portal hypertension (SPH) is a rare clinical syndrome. The purpose of this study was to assess the clinical outcomes and safety of splenic artery embolization (SAE) in the treatment of SPH.

Methods

This retrospective study included 39 SPH patients who underwent SAE treatment between August 2009 and May 2021. The cases had esophageal, gastric, or ectopic varices detected by endoscopy or enhanced CT, with symptoms or signs of upper gastrointestinal (GI) bleeding and/or postprandial fullness. Clinical symptom improvement rate, complications, and symptomatic recurrence rate were observed and analyzed after treatment.

Results

All the procedures were performed successfully. Of all patients, 17 received the 2-step complete SAE procedure, 19 received only the first step of the 2-step protocol (i.e., partial splenic embolization [PSE] procedure), and the remaining three received the 1-step complete SAE procedure. After the procedures, the symptoms completely disappeared in all patients, and the main complications were post-embolization syndromes, with 27 patients (69.2%) developing a low-grade fever, 24 (61.5%) developing abdominal pain and 4 (10.3%) developing nausea or mild vomiting. During the prolonged follow-up, varicose veins were gradually reduced as detected by enhanced CT; liver function parameters and platelet count remained in the normal range. Only one patient who underwent PSE treatment developed upper GI rebleeding 7 months after the procedure.

Conclusion

Two-step complete SAE is a safe and feasible procedure for the treatment of symptomatic SPH.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was funded by the National Natural Science Foundation of China (81873917).

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