What is splenic embolization?

Splenic (artery) embolization is an endovascular technique for treatment of splenic and splenic artery pathology as an alternative to splenic artery ligation or splenectomy. It often results in successfully treating the underlying pathology, while maintaining at least partial splenic function.

Does spleen work after embolization?

All studies used different parameters to assess splenic function. None of them reported a OPSI after splenic embolization. Eleven studies found a preserved splenic function after SAE, in both adults and children. Conclusion: All but one studies on the long term effects of SAE indicate a preserved splenic function.

What are splenic varices?

Varices develop across the esophagus and stomach from the pressure in the portal vein. The backup of pressure also causes the spleen to become enlarged.

How does splenic vein thrombosis cause gastric varices?

Blockage of the splenic vein leads to sinistral portal hypertension and the development of collateral vessels to circumvent the thrombus. Gastric varices form when pressure builds up within the submucosal veins of the fundus.

What causes isolated gastric varices?

Core tip: Isolated gastric varices occur in patients with splenic vein occlusion caused by thrombosis, stenosis, or cancer, such as pancreatic, colon, gastric, or renal cancers.

How are bleeding gastric varices treated in splenic vein thrombosis?

Splenic artery embolization for the treatment of bleeding gastric varices secondary to splenic vein thrombosis Splenic vein thrombosis can lead to gastric varices. Subsequent upper gastrointestinal bleeding may ensue related to the change in venous outflow to the portal system.

What is the pathophysiology of splenic vein thrombosis?

Splenic vein thrombosis can lead to gastric varices. Subsequent upper gastrointestinal bleeding may ensue related to the change in venous outflow to the portal system. Vascular surgeons are infrequently asked to assist in the management of this entity.

How are ectopic esophageal and rectal varices diagnosed?

Although clinically significant esophageal and rectal varices are typically visible endoscopically, ectopic varices may require multiplanar portal venous phase computed tomography or magnetic resonance imaging for diagnosis.

When is recanalization indicated in the treatment of hepatic venous insufficiency?

A subset of patients with obstructed hepatic venous outflow or portal venous inflow should be considered for recanalization. Splenic artery embolization may be considered for reduction of portal pressure in selected patients, particularly when hypersplenism or splenic vein occlusion is a prominent feature.