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

Authors Zhang L, Zhang ZG, Long X, Liu FL, Zhang WG

Received 14 October 2019

Accepted for publication 29 January 2020

Published 19 February 2020 Volume 2020:13 Pages 135—140

DOI https://doi.org/10.2147/RMHP.S234628

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Kent Rondeau


Lei Zhang, Zhan-Guo Zhang, Xin Long, Fei-Long Liu, Wan-Guang Zhang

Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, People’s Republic of China

Correspondence: Wan-Guang Zhang
Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan 430030, People’s Republic of China
Tel +86-27-83665213
Fax +86-27-83662851
Email wgzhuang@medmail.com.cn

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

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