Complications arising from splenic artery embolization: a review of an 11-year experience

BACKGROUND: Splenic artery embolization (SAE) is a staple adjunct in the management of blunt splenic trauma. We examined complications of SAE over an 11-year period. METHODS: Patients who underwent SAE were identified. Demographic data and the location of the SAEdproximal, distal, or combineddwere noted. Major and minor complications were identified. RESULTS: Of 1,383 patients with blunt splenic trauma, 298 (21.5%) underwent operative management, and 1,085 (78.5%) underwent nonoperative management (NOM). SAE was performed in 8.1% of the NOM group. Major complications which occurred in 14% of patients, included splenic abscesses, infarction, cysts, and contrast-induced renal insufficiency. Three-fourths of patients with major complications underwent distal embolization. There were more complications in patients who underwent distal embolization (24% distal vs 6% proximal alone; P 5.02). Minor complications, which occurred in 34% of patients, included left-sided pleural effusions, coil migration, and fever. CONCLUSIONS: SAE is a useful tool for managing splenic injuries. Major and minor complications can occur. Distal embolization is associated with more major complications.