Clinical implementation of partial splenic artery embolization for the prevention of recurrent bleeding from esophageal varices in portal hypertension-Reference-Cited by-同舟云学术

Clinical implementation of partial splenic artery embolization for the prevention of recurrent bleeding from esophageal varices in portal hypertension

Published:2024 Issue:5 Volume:77 Page:932-936
ISSN:0043-5147
Container-title:Wiadomości Lekarskie
language:en
Short-container-title:Wiad Lek

Author:

Kozlov Sergii N.¹,Ivanchov Pavlo V.¹,Kondratiuk Vadim A.²,Nikishyn Oleksandr L.³,Altman Igor V.³,Leshchynka Natalia O.¹,Kozlov Oleksandr S.¹

Affiliation:

1. BOGOMOLETS NATIONAL MEDICAL UNIVERSITY KYIV, UKRAINE

2. STATE INSTITUTION ≪NATIONAL INSTITUTE OF SURGERY AND TRANSPLANTOLOGY N.A. O. SHALIMOV NATIONAL MEDICAL SCIENCES ACADEMY OF UKRAINE≫, KYIV, UKRAINE

3. STATE INSTITUTION ≪SCIENTIFIC-PRACTICAL CENTER OF ENDOVASCULAR NEURORADIOLOGY NAMS OF UKRAINE≫, KYIV, UKRAINE

Abstract

Aim: To evaluate the effectiveness of PSAE for secondary prevention of VB episodes in patients with chronic liver disease (CLD) and CSPH. Materials and Methods: One hundred twenty patients (from 2008 to 2020) were submitted of PSAE as secondary prevention treatment. The results of the treatment of 27 patients between 2008 and 2012 (first period) were compared with those of 93 patients treated with PSAE since 2013 (second period), as procedure and management protocol were modificated. VB recurrence rate and mortality (related and non-related to bleeding episodes) were defined as study end-points in both groups at 12-months follow-up. Results: At 12-months follow-up, 11 (40,7 %) and 54 (58,1 %) patients in groups 1 and 2, respectively, were free from VBs (p=0,129). Overall mortality rate was significantly higher in group 1, as compared to group 2: 10 (37,0 %) versus 6 (6,4 %) patients, respectively (p<0,001), − due to higher frequency of fatal VB events (7 (26,0 %) vs. 3 (3,2 %) patients, respectively; p=0,001). Conclusions: PSAE is an effective treatment for secondary prevention of VB in patients with CLD and CSPS. The management protocol modification resulted in the decrease in overall mortality rate and mortality related to recurrent VB episodes.

Publisher

ALUNA

Reference21 articles.

1. 1. Bolognesi M, Di Pascoli M, Verardo A, Gatta A. Splanchnic vasodilation and hyperdynamic circulatory syndrome in cirrhosis. World J Gastroenterol. 2014;20(10):2555-63. doi: 10.3748/wjg.v20.i10.2555.

2. 2. de Franchis R, Bosch J, Garcia-Tsao G et al. Baveno VII - Renewing consensus in portal hypertension. J Hepatol. 2022;76(4):959-974. doi: 10.1016/j.jhep.2021.12.022.

3. 3. Nikishyn OL, Kozlov SI, Altman IV et al. Modifikatsiya sposobu endovaskulyarnoyi embolizatsiyi selezinkovoyi arteriyi. [Modification of the method of endovascular embolization of the splenic artery.] Endovaskulyarna neyrorenthenokhirurhiya. 2017;4:52-59. (Ukrainian)

4. 4. Ishikawa T. Efficacy of interventional radiology in the management of portal hypertension: A narrative review. Medicine (Baltimore). 2022;101(33):e30018.

5. 5. Bhatia A, Bryant EH, Fox B et al. Long-Term Effects of Proximal Splenic Artery Embolization on Splenic Volume and Platelet Count. Ann Vasc Surg. 2023;89:166-173. doi: 10.1016/j.avsg.2022.09.055.