Endovascular embolization results in treatment of I-IV grade traumatic spleen rupture: single centre study

Purpose: Splenic artery embolization (SAE) is commonly used for lowgrade traumatic spleen rupture (TSR) (I-II), however hemodynamically stable patients with high-grade TSR (III-V) could also beneft from SAE. The purpose of this study was to: 1. evaluate etiology and injury grade of TSR; 2. analyze association between injury grade (IG) and infammatory parameter change after SAE. Materials and Methods: In this retrospective single center study patients undergoing SAE for TSR from 2014 to 2020 were included. IG assesed with American Association for Surgery of Trauma (AAST) scale. Blood sample analysis performed on admission and on 1st, 4th, 7th, 10th hospitalization day. Results: 20 patients included, mean age: 45.30 years. TSR ethiology: 50% - polytrauma, 35%- fall from height, 15%- forensic trauma. According to AAST scale: 5% - I IG, 15% -II IG, 45% - III IG, 35%- IV IG. SAE was performed with coils. In 87% of cases proximal SAE performed from bifurcation to middle of the artery. In 13% additional superselective distal SAE performed. Compared to admission, on 10th day after SAE absolute leukocyte count and C-reactive protein (CRP) percentual changes were: I IG leukocytes: +627%, CRP: +217% (p<0.05), II IG leukocytes: -29.6%, CRP: +77% (p<0.05), III IG leukocytes: +55.2%, CRP: +1093% (p<0.05), IV IG leukocytes: -39%, CRP: +93% (p<0.05). One patient developed splenomegaly that required splenectomy; no other signifcant complications were recognized. Conclusion: The dominant cause of TSR in Latvia- polytrauma. SAE can be considered as alternative to splenectomy in hemodynamically stable patients with low and high-grade TSR with minor complication risk