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- W2584686880 abstract "To investigate the impact of partial splenic embolization (PSE) on three key hematological indices: hemoglobin, white blood cell (WBC) count, and platelet count. To determine the time over which the effect persists out to 5 years, and the rate of major complications associated with the intervention in the non-emergent setting. This is a single-center retrospective study evaluating 102 patients who underwent PSE between January 2000 and May 2016. Inclusion criteria consisted of splenomegaly confirmed by imaging and at least one of the following associated cytopenias: hemoglobin less than 10 g/dL, WBC count less than 1,500 uL-1, and/or platelet count less than 100,000 uL-1. Patients with cytopenias related to alternative etiologies were excluded, as were patients who underwent PSE primarily for the treatment of recurrent variceal hemorrhage. 38 of 102 patients met criteria, for a total of 40 PSEs. Mean laboratory follow up time was 1.5 years. No significant effect was seen on median hemoglobin values beyond 2 weeks post PSE. There was a significant and sustained increase in both median WBC counts (from 3,400 uL-1 at baseline to 4,900 uL-1 at 1.5 years) and platelet count (from 65,000 uL-1 to 124,000 uL-1) out to 1.5 years. Median platelet count was persistently elevated, though not significant, in the 3 patients followed out to 5 years. The intervention had no significant impact on MELD-Na or Child-Pugh (CP) score. In 6 out of 40 PSEs (15%) a serious complication resulted, which included pleural effusion, ascites, spontaneous bacterial peritonitis, pneumonia, and inferior vena cava thrombus requiring surgical intervention. PSE is efficacious in increasing WBC and platelet counts out to 1.5 years in patients with splenomegaly associated cytopenias. Platelet counts likely remain elevated as far out as 3 years. With regard to safety, PSE has minimal impact on prognostic factors for chronic liver disease, which is a common cause of hypersplenism. However, the intervention is associated with a significant complication rate and special care should be taken when selecting patients for PSE, as they frequently have multiple comorbidities." @default.
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- W2584686880 date "2017-02-01" @default.
- W2584686880 modified "2023-09-26" @default.
- W2584686880 title "Efficacy and safety of partial splenic embolization in patients with splenomegaly associated cytopenias" @default.
- W2584686880 doi "https://doi.org/10.1016/j.jvir.2016.12.755" @default.
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