Comparative Study of Patients that Underwent Splenectomy for Immune Thrombocytopenic Purpura With and Without Splenic Artery Embolization

Basis and Objectives: Platelets and/or red blood cells transfusion usually are performed in patients with Immune Thrombocytopenic Purpura (ITP) who are submitted to splenectomy. The purpose of this study is to test if preoperative embolization of splenic artery is able to prevent platelets and/or red blood cells transfusion. Patients and Methods: All patients submitted to splenectomy for purpura between October 1999 and April 2008 by the same surgical team were enrolled in the study. The first 18 patients were not submitted to embolization and were compared to the follow 11 consecutive patients in whom embolization was performed. Results: The platelets count in the group who embolization was performed rose from average 7000 u/μl before the procedure to 75000 u/μl after the procedure. Platelets and red blood cells transfusion was not necessary in the group submitted to embolization compare to the group without preoperative embolization, 12 patients with platelets transfusion (p=0,001) and 9 patients with red blood cells transfusion (p=0,01). In this study platelets and red blood cells were not transfused in patients submitted to embolization of splenic artery before splenectomy. Conclusion: Our results seem to confirm the advantages of preoperative embolization of the splenic artery for patients that underwent splenectomy for ITP when compared to patients without embolization. The data obtained in this study demonstrated that embolization consists of a safe and effective procedure to prevent transoperative bleeding and the necessity of hemoderivates.