Impact of Portal Hypertension on Adverse Events after Splenic Arterial Aneurysm Embolization

Ahsun Riaz*, Pouya Entezari, Asad Malik, Wali Badar, Stephen Scheller, Ahmed Gabr, Bartley Thornburg, Stephen Seedial, Justin Boike, Scott Resnick, Kent Sato, Daniela Ladner, Christopher Moore, Daniel Ganger, James Donaldson, Laura Kulik, Robert J. Lewandowski, Brian S. Funaki, Osman Ahmed, Juan Carlos CaicedoRiad Salem

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Purpose: To evaluate the outcomes of splenic artery aneurysm (SAA) embolization and compare adverse event (AE) rates after embolization in patients with and without portal hypertension (PHTN). Materials and Methods: A retrospective review of all patients who underwent embolization of SAAs at 2 institutions was performed (34 patients from institution 1 and 7 patients from institution 2). Baseline demographic characteristics, preprocedural imaging, procedural techniques, and postprocedural outcomes were evaluated. Thirty-day postprocedural severe and life-threatening AEs were evaluated using the Society of Interventional Radiology guidelines. Thirty-day mortality and readmission rates were also evaluated. t test, χ2 test, and/or Fisher exact test were used for the statistical analysis. Results: There was no statistically significant difference between patients with and without PHTN in the location, number, and size of SAA(s). All procedures were technically successful. There were 13 (32%) patients with and 28 (68%) patients without PHTN. The 30-day mortality rate (31% vs 0%; P =.007), readmission rates (61% vs 7%; P <.001), and severe/life-threatening AE rates (69% vs 0%; P <.001) were significantly higher in patients with PHTN than in those without PHTN. Conclusions: There was a significantly higher mortality and severe/life-threatening AE rate in patients with PHTN than in those without PHTN. SAAs in patients with PHTN need to be managed very cautiously, given the risk of severe/life-threatening AEs after embolization.

Original languageEnglish (US)
Pages (from-to)1519-1526.e1
JournalJournal of Vascular and Interventional Radiology
Volume33
Issue number12
DOIs
StatePublished - Dec 2022

Funding

A.R. received consulting fees from Boston Scientific. J.B. reports grants from W.L. Gore & Associates and consulting fees from W.L. Gore & Associates and Fuji Film. S.R. has received payment for numerous cases for expert review (both plaintiff and defense). D.G. has received payment or honoraria from Gilead Speaker Bureau and for participation on a Data Safety Monitoring or Advisory Board from Alexion. J.D. has received payment for Expert Witness Consulting fees, unrelated to this work, and plane, meeting registration, and lodging support for attending International Pediatric Radiology Congress October 2021. R.J.L. has received consulting fees from Boston Scientific, BD, and Varian and payments or honoraria from Boston Scientific and is a member of the Society of Interventional Radiology Executive Council. None of the other authors have identified a conflict of interest.

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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