REGULAR CONTENT
Final ID
411
Type
Original Scientific Research-Oral or Pos
Authors
Y Zhang1, C Shilagani1, S Maddineni2, A Gilet1, Y Zhang1
Institutions
1Westchester Medical Center, Valhalla, NY, 2N/A, Chappaqua, NY
Purpose
1. To investigate the indication, technical considerations, and efficacy of splenic artery embolization (SAE) for nonoperative management of blunt splenic trauma.2. To review initial CT findings, CT grading of splenic injury, and the feasibility of utilizing CT for triaging patients for SAE, observation or surgery.3. To identify an algorithm for management of blunt splenic injury and indication for SAE.
Materials & Methods
We conducted a 10 year retrospective chart review of trauma patients with blunt splenic injuries at our institution. Diagnosis was made by CT examination. Appropriate IRB approval was obtained. The initial CT scans of patients who underwent observation, SAE or surgery for blunt splenic injury were re-evaluated. The technical aspects and treatment outcomes of SAE were investigated. An algorithm for managing trauma patients with splenic injury was discussed via search of literature.
Results
Preliminary evaluation of 130 patients who underwent SAE suggests that initial CT of active extravasation or pseudoaneurysm formation has the strongest predictability for splenic angiography and SAE. Higher AAST injury grades is associated with nonoperative management with splenic angiography as well as higher rate of failure with SAE and the need for surgical management. SAE is safe and efficacious. Of the 130 patients reviewed, <5% of patients developed severe complication with splenic abscess.
Conclusions
SAE has an increasing role in the nonoperative management of blunt traumatic splenic injuries. Patients with higher (>AAST grade III) splenic injury scale are likely to benefit from SAE. CT based AAST grading criteria is not sufficient in triaging patients for observation, SAE or surgery. An algorithm that includes additional features on CT and clinical presentation is necessary to appropriately identify management options. Splenic abscess is a severe but rare complication of SAE, and careful interval monitoring with CT or US during the postembolization period reduces the rate of complications.
Final ID
411
Type
Original Scientific Research-Oral or Pos
Authors
Y Zhang1, C Shilagani1, S Maddineni2, A Gilet1, Y Zhang1
Institutions
1Westchester Medical Center, Valhalla, NY, 2N/A, Chappaqua, NY
Purpose
1. To investigate the indication, technical considerations, and efficacy of splenic artery embolization (SAE) for nonoperative management of blunt splenic trauma.2. To review initial CT findings, CT grading of splenic injury, and the feasibility of utilizing CT for triaging patients for SAE, observation or surgery.3. To identify an algorithm for management of blunt splenic injury and indication for SAE.
Materials & Methods
We conducted a 10 year retrospective chart review of trauma patients with blunt splenic injuries at our institution. Diagnosis was made by CT examination. Appropriate IRB approval was obtained. The initial CT scans of patients who underwent observation, SAE or surgery for blunt splenic injury were re-evaluated. The technical aspects and treatment outcomes of SAE were investigated. An algorithm for managing trauma patients with splenic injury was discussed via search of literature.
Results
Preliminary evaluation of 130 patients who underwent SAE suggests that initial CT of active extravasation or pseudoaneurysm formation has the strongest predictability for splenic angiography and SAE. Higher AAST injury grades is associated with nonoperative management with splenic angiography as well as higher rate of failure with SAE and the need for surgical management. SAE is safe and efficacious. Of the 130 patients reviewed, <5% of patients developed severe complication with splenic abscess.
Conclusions
SAE has an increasing role in the nonoperative management of blunt traumatic splenic injuries. Patients with higher (>AAST grade III) splenic injury scale are likely to benefit from SAE. CT based AAST grading criteria is not sufficient in triaging patients for observation, SAE or surgery. An algorithm that includes additional features on CT and clinical presentation is necessary to appropriately identify management options. Splenic abscess is a severe but rare complication of SAE, and careful interval monitoring with CT or US during the postembolization period reduces the rate of complications.