Splenic arterial interventions are increasingly performed to treat various clinical conditions, including abdominal trauma, hypersplenism, splenic arterial aneurysm, portal hypertension, and splenic neoplasm. When clinically appropriate, these procedures may provide an alternative to open surgery. They may help to salvage splenic function in patients with posttraumatic injuries or hypersplenism and to improve hematologic parameters in those who otherwise would be unable to undergo high-dose chemotherapy or immunosuppressive therapy. Splenic arterial interventions also may be performed to exclude splenic artery aneurysms from the parent vessel lumen and prevent aneurysm rupture; to reduce portal pressure and prevent sequelae in patients with portal hypertension; to treat splenic artery steal syndrome and improve liver perfusion in liver transplant recipients; and to administer targeted treatment to areas of neoplastic disease in the splenic parenchyma. As the use of splenic arterial interventions increases in interventional radiology practice, clinicians must be familiar with the splenic vascular anatomy, the indications and contraindications for performing interventional procedures, the technical considerations involved, and the potential use of other interventional procedures, such as radiofrequency ablation, in combination with splenic arterial interventions. Familiarity with the complications that can result from these interventional procedures, including abscess formation and pancreatitis, also is important.

https://pubs.rsna.org/doi/pdf/10.1148/rg.25si055504

Splenic arterial interventions: anatomy, indications, technical considerations, and potential complications.

http://www.scvir.org/clinical/cpg/QI7.pdf

Quality improvement guidelines for percutaneous transcatheter embolization: Society of interventional radiology standards of practice committee

http://www.scvir.org/clinical/cpg/S237.pdf

Quality improvement guidelines for percutaneous transcatheter embolization.

Partial Splenic Embolization in the Treatment of Patients with Portal Hypertension: A Review of the English Language Literature

Radionuclide evaluation of renal transplants

Seven hypertensive patients underwent percutaneous transluminal angioplasty for relief of arterial stenosis complicating renal allotransplantation. Five had end-to-side anastomosis of the donor renal artery to the recipient external iliac artery, and two had end-to-end anastomosis of the donor renal artery to the recipient internal iliac artery. Each patient had developed hypertension (blood pressure greater than 145/95 mm Hg), elevated peripheral venous plasma renin, and six demonstrated decrease in renal function as detected by an increase in serum creatinine at least 2 months after transplantation and without evidence of rejection. Angioplasty was technically successful without significant complications and blood pressure and biochemical abnormalities were improved or stabilized in all seven patients.

Renal transplant arterial stenosis: percutaneous transluminal angioplasty

Immunosuppressive therapy is necessary in the treatment and prevention of rejection in renal transplant recipients Unfortunately, these patients may become intolerant to this therapy when it is complicated by hypersplenism with leukopenia and/or thrombocytopenia The therapy must then be either decreased or stopped, thus preventing adequate treatment or prevention or rejection Splenectomy has been used to treat the hypersplenism to break this cycle It requires operative intervention with general anesthesia and prolonged hospitalization, and has been associated with fulminant bacterial septicemia For these reasons, partial splenic embolization was offered to our patients as an alternative to splenectomy in the treatment of their immunosuppressive therapy intolerance due to hypersplenism Six patients with acute rejection episodes and one patient on dialysis awaiting transplantation underwent partial splenic embolization It corrected the hypersplenism in each case without significant complications allowing control of the rejection episode with adequate immunosuppressive therapy in six patients Strict aseptic technique, pain control, and antibiotic prophylaxis are advised to prevent the complications of splenic abscess, rupture, or septicemia when this technique is used

https://www.ajronline.org/doi/pdfplus/10.2214/ajr.138.3.451

Partial splenic embolization for hypersplenism in renal transplantation

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Renal transplant arterial stenosis: percutaneous transluminal angioplasty

Partial splenic embolization for hypersplenism in renal transplantation