Effects and complications of partial splenic artery embolization for portal hypertension

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  • Hayashi Manabu
    Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine
  • Abe Kazumichi
    Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine
  • Watanabe Ko
    Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine Department of Endoscopy, Fukushima Medical University Hospital
  • Takahashi Atsushi
    Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine
  • Kanno Yukiko
    Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine
  • Okai Ken
    Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine
  • Imaizumi Hiromichi
    Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine
  • Takagi Tadayuki
    Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine
  • Hikichi Takuto
    Department of Endoscopy, Fukushima Medical University Hospital
  • Obara Katsutoshi
    Department of Endoscopy, Fukushima Medical University Hospital
  • Watanabe Hiroshi
    Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine
  • Ohira Hiromasa
    Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine

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Other Title
  • 門脈圧亢進症に対する部分的脾動脈塞栓術の効果と合併症の検討

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Abstract

In recent years, the safety of partial splenic artery embolization (PSE) has been established, and is expected to contribute to improvements in thrombocytopenia and esophagogastric varices. In this study, we investigated the effects and complications of PSE performed for portal hypertension associated with chronic liver disease. Subjects were 22 patients (mean age, 60.9 years; 15 men and 7 women) who underwent PSE at our hospital. These patients were stratified according to Child-Pugh classification into 6 patients as Child-Pugh A, 15 as B and 1 as C. Nine patients had hepatocellular carcinoma, and 15 had esophagogastric varices. Child A/B/C was 6/15/1. We examined blood cell counts, liver function, upper gastrointestinal endoscopic findings, and complications before, 2 weeks after, and 24 weeks after PSE. White blood cell and platelet counts were significantly increased at 2 and 24 weeks after treatment, compared to those before treatment (p < 0.05). Eight of 9 patients with esophagogastric varices who underwent PSE had no recurrence after endoscopic injection sclerotherapy. With respect to serious complications, 2 patients developed DIC where TAT was more increased compared to patients without DIC, indicating that TAT could distinguish DIC from non-DIC.

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