Preventive Proximal Splenic Artery Embolization for High-Grade AAST-OIS Adult Spleen Trauma without Vascular Anomaly on the Initial CT Scan: Technical Aspect, Safety, and Efficacy—An Ancillary Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Patients
2.3. Procedures
2.4. Technical Assessment
2.5. Safety and Efficacy Assessments
2.6. Statistics
3. Results
3.1. Patients
3.2. Technical Results
3.3. Safety, Efficacy, and One-Month Splenic Salvage
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Grade | Imaging Findings |
---|---|
I | Subcapsular hematoma < 10% surface area Parenchymal laceration < 1 cm depth capsular tear |
II | Subcapsular hematoma 10–50% surface area; intraparenchymal hematoma < 5 cm Parenchymal laceration 1–3 cm |
III | Subcapsular hematoma > 50% surface area; ruptured subcapsular or intraparenchymal hematoma ≥ 5 cm Parenchymal laceration > 3 cm depth |
IV | Any injury in the presence of a splenic vascular injury or active bleeding confined within the splenic capsule Parenchymal laceration involving segmental or hilar vessels producing > 25% devascularization |
V | Any injury in the presence of a splenic vascular injury with active bleeding extended beyond the spleen into the peritoneum Shattered spleen |
Characteristics | Patients |
---|---|
Sex | |
Male | 47/57 (82.4%) |
Female | 10/57 (17.6%) |
Age | 31 (SD = +/−7.5 years) |
Circumstances of injury | |
Traffic | 35/57 (61.5%) |
Domestic | 2/57 (3.5%) |
Sport | 14/57 (24.6%) |
Work | 3/57 (5.2%) |
Other | 3/57 (5.2%) |
AAST-OIS grade | |
3 | 33/57 (57.9%) |
4 | 23/57 (40.3%) |
5 | 1/57 (1.8%) |
NISS | 19.6 (SD = +/−8.1) |
AVP (n = 29) | POD (n = 18) | Microcoils (n = 10) | p | |
---|---|---|---|---|
OIS-AAST grade | ||||
Grade 3 | 18 | 11 | 4 | 0.48 |
Grade 4 | 10 | 7 | 6 | 0.40 |
Grade 5 | 1 | 0 | 0 | 1 |
Technical success (%) | 100 | 100 | 60 | <0.01 |
Clinical efficacy (%) | 96.6 | 94.4 | 100 | 1 |
Procedure time (min, mean +/− SD) | 52.3 (41.4) | 61.4 (39.3) | 67 (68.7) | 0.2 |
Contrast (mL, mean +/−SD) | 57 (25.8) | 83.2 (56.4) | 88.3 (57.8) | <0.01 |
Spleen parenchyma J30 (%, mean+/−SD) | 90.5 (11.1) | 82.8 (17.9) | 82.9 (10.3) | <0.01 |
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Sammoud, S.; Ghelfi, J.; Barbois, S.; Beregi, J.-P.; Arvieux, C.; Frandon, J. Preventive Proximal Splenic Artery Embolization for High-Grade AAST-OIS Adult Spleen Trauma without Vascular Anomaly on the Initial CT Scan: Technical Aspect, Safety, and Efficacy—An Ancillary Study. J. Pers. Med. 2023, 13, 889. https://doi.org/10.3390/jpm13060889
Sammoud S, Ghelfi J, Barbois S, Beregi J-P, Arvieux C, Frandon J. Preventive Proximal Splenic Artery Embolization for High-Grade AAST-OIS Adult Spleen Trauma without Vascular Anomaly on the Initial CT Scan: Technical Aspect, Safety, and Efficacy—An Ancillary Study. Journal of Personalized Medicine. 2023; 13(6):889. https://doi.org/10.3390/jpm13060889
Chicago/Turabian StyleSammoud, Skander, Julien Ghelfi, Sandrine Barbois, Jean-Paul Beregi, Catherine Arvieux, and Julien Frandon. 2023. "Preventive Proximal Splenic Artery Embolization for High-Grade AAST-OIS Adult Spleen Trauma without Vascular Anomaly on the Initial CT Scan: Technical Aspect, Safety, and Efficacy—An Ancillary Study" Journal of Personalized Medicine 13, no. 6: 889. https://doi.org/10.3390/jpm13060889