Negative Splenic Angiography in Blunt Trauma: Does Embolization Affect Splenic Salvage?

Authors

• Rachel Yoo, Division of Acute Care Surgery/Trauma, Department of Surgery, 6823Reading Hospital, Reading, PA, USA; 419713Tower Health System, Reading, PA, USA.Follow
• Davin Evanson
• Michael Gaziano
• Alison Muller, Division of Acute Care Surgery/Trauma, Department of Surgery, 6823Reading Hospital, Reading, PA, USA; 419713Tower Health System, Reading, PA, USA.Follow
• Anthony Martin, Division of Acute Care Surgery/Trauma, Department of Surgery, 6823Reading Hospital, Reading, PA, USA; 419713Tower Health System, Reading, PA, USA.Follow
• Nikunj Chauhan, Department of Interventional Radiology, 6823Reading Hospital, Reading, PA, USA; 419713Tower Health System, Reading, PA, USA.Follow
• Christopher Butts, Division of Acute Care Surgery/Trauma, Department of Surgery, 6823Reading Hospital, Reading, PA, USA; 419713Tower Health System, Reading, PA, USA.Follow
• Vicente Cortes, Division of Acute Care Surgery/Trauma, Department of Surgery, 6823Reading Hospital, Reading, PA, USA; 419713Tower Health System, Reading, PA, USA.Follow
• Eugene Reilly, Division of Acute Care Surgery/Trauma, Department of Surgery, 6823Reading Hospital, Reading, PA, USA; 419713Tower Health System, Reading, PA, USA.Follow
• Peter K Bamberger, Division of Acute Care Surgery/Trauma, Department of Surgery, 6823Reading Hospital, Reading, PA, USA; 419713Tower Health System, Reading, PA, USA.Follow
• Thomas A Geng, Division of Acute Care Surgery/Trauma, Department of Surgery, 6823Reading Hospital, Reading, PA, USA; 419713Tower Health System, Reading, PA, USA.Follow
• Adrian Ong, Division of Acute Care Surgery/Trauma, Department of Surgery, 6823Reading Hospital, Reading, PA, USA; 419713Tower Health System, Reading, PA, USA.Follow

Document Type

Article

Publication Date

2-15-2023

Abstract

Angioembolization in blunt splenic trauma is used to maximize splenic preservation. Superiority of prophylactic embolization over expectant management in patients with a negative splenic angiography (SA) is debated. We hypothesized that embolization in negative SA would be associated with splenic salvage. Of 83 patients undergoing SA, 30 (36%) had a negative SA. Embolization was performed in 23 (77%). Grade of injury, contrast extravasation (CE) on computed tomography (CT) or embolization were not associated with splenectomy. In 20 patients with either a high-grade injury or CE on CT, 17 (85%) underwent embolization with a failure rate of 24%. In the remaining 10 without high-risk features, 6 underwent embolization with a 0% splenectomy rate. Despite embolization, the failure rate of nonoperative management (NOM) remains significant in those with high-grade injury or CE on CT. A low threshold for early splenectomy after prophylactic embolization is needed.

Publication Title

The American surgeon

First Page

31348231157863

Last Page

31348231157863

Comments

online ahead of print

Recommended Citation

Yoo, R., Evanson, D., Gaziano, M., Muller, A., Martin, A., Chauhan, N., Butts, C., Cortes, V., Reilly, E., Bamberger, P., Geng, T., & Ong, A. (2023). Negative Splenic Angiography in Blunt Trauma: Does Embolization Affect Splenic Salvage?. The American surgeon, 31348231157863-31348231157863. https://doi.org/https://doi.org/10.1177/00031348231157863