Role of partial splenic arterial embolization for hypersplenism in patients with liver cirrhosis and thrombocytopenia.

BACKGROUND Hypersplenism is traditionally treated by surgical splenectomy. Transcatheter ablation of splenic parenchyma is an alternative treatment modality. METHODS We evaluated the efficacy and safety of partial splenic arterial embolization in 10 patients with chronic liver disease and hypersplenism with thrombocytopenia (platelet count <80,000/microL). RESULTS At six months follow up, median (range) platelet counts (134.5 [71.5-164] x 10(3)/microL) were significantly higher than those before treatment (33.5 [23-39] x 10(3)/microL; p<0.05]). All patients developed post-embolization syndrome. Left-sided pleural effusion and increase in amount or new development of ascites occurred in six and five patients, respectively. CONCLUSIONS Our data suggest that partial splenic arterial embolization leads to an increase in platelet count in patients with thrombocytopenia due to chronic liver disease and hypersplenism. However, it is often associated with complications.