Table 1

Efficacy of splenic embolization

Author, yrStudy typeNo. of patients embolizedIndicationsType of embolizationOverall success of NOM, %Success of embolization, %
Sclafani et al. (44) 1995Prospective60Arterial extravasation on admission angiographyProximal, distal, or both97 (AAST IV: 84)93
Hagiwara et al. (48) 1996Prospective15Angiorgraphic evidence of arterial extravasation and/or arterial disruption or major arteriovenous fistulaProximal, distal, or both9387
Davis et al. (18) 1998Retrospective26Contrast blush on CT, confirmed as a parenchymal pseudoaneurysm on angiographyDistal9477 (technical failure)
Haan et al. (47) 2001Retrospective40*Celiac angiography in all stable patients with splenic injury as seen on CT scan; those with proven vascular injury (arteriovenous fistula, pseudoaneurysm or contrast extravasation) underwent embolizationProximal, distal, or both92 (AAST IV–V: > 70)92
Haan et al. (40) 2003Retrospective35Angiorarphy for all grade III–V injuries as seen on CT scan, or any grade if there was evidence of intraparenchymal vascular injuryProximal, distal, or both100100†
Haan et al. (46) 2004Retrospective, multicentre review (4 institutions)140Pseudoaneurysm or active bleeding on CT scan obtained at the time of admission; or significant hemoperitoneum and high grade splenic injury/vascular injury as seen on CT scanProximal, distal, or both87 (AAST IV–V: 83)86.5
Haan et al. (60) 2005Retrospective132Angioembolization for all grade III–V injuries as seen on CT scan, or any grade if evidence of intraparenchymal vascular injuryProximal, distal, or both94 (AAST IV–V: > 80)90
Liu et al. (43) 2004Prospective6Significant hemoperitoneum or extravasation of contrast media as seen on CT scan, grade IV or V splenic injury, falling hematocrit level and progressive need for blood transfusions, and recurrent hypotension despite fluid resuscitationDistal8987
Dent et al. (49) 2004Retrospective13No formal algorithm was used; however, indications included splenic vascular blush, persistent tachycardia and a falling hematocrit level (that could not be explained by other injuries)Distal9892
Smith et al. (58) 2006Retrospective41Arterial blush as seen on CT scanProximal or distal8673
Bessoud et al. (54) 2006Retrospective37Grade III–V splenic injury, or evidence of contrast extravasation or blush as seen on CT scanProximal9497

  • AAST = American Association for the Surgery of Trauma; CT = computed tomography; NOM = nonoperative management.

  • ↵* Of 126 who underwent angiography.

  • ↵† One patient bled and required repeat angiography with embolization, but did not require laparotomy.