Experimental Study On Percutaneous Splenic Arterial Embolization To Treat Traumatic Splenic Injuries

Aim : To research the efficacy of percutaneous splenic arterial embolization to treat traumatic splenic injuries, and changes of the blood pressure of branches of splenic artery. Materials and Methods : 7 mini-pigs ( 25 ~ 35Kg), gelfoam , 6F catheter shealth, 6F right coronary catheter, 0.038 guidewire. Under general anesthethia, tracheal tube insertion, sterilization and drapes of abdominal and both lower extremities skin, when touched the femoral pulse ,dissected the femoral artery , using the Seldinger technique, 6F catheter sheath had been inserted into femoral artery. Then did upper abdominal paramedian incision , according to abdominal standard surgical rules, opened the abdominal cavity ,exposed the spleen, and part of spleen had been moved out of abdominal cavity . According to ASST , splenic wound grade criteria ,the spleen had been artificial injuried , catheterized 5F right coronary catheter to spleen artery, radiography confirmed that catheter had crossed the dorsal pancreatic artery, spleen artery had been embolized with 3 ~ 5 gelfoam 3mmx10mm-trips, after confirming splenic artery had been obstructed by radiography, then begun to calculate splenic wound bleeding termination time. After bleeding stopped, pulled out catheter and sheath. Another group pigs did not do embolization , only calculated spleen wound bleeding termination time, results : ( 1 ) Two groups have statistic significance discrepancy of bleeding termination time , P < 0. 05, embolization of splenic artery is helpful for the termination of the bleeding of splenic rupture. (2 ) Executed pigs after 1 week, opened abdominal cavity , showed spleen wound had been sealed by the greater omentum, did not discover new bleeding site. Took out spleen and splenic artery for pathologic examination, pathologic sections showed splenic wound fissure had been been sealed by the greater omentum, traumatic wound had been healed up, did not see splenic infarct lesion; it was blocked by gelatin sponge and thrombus in themain trunk of splenic. ( 3 ) Before embolization,, blood pressure 168 mmHg in branches of splenic artery and 174 mmHg of blood pressure in spleen artery trunk. After embolization, blood pressure had decreased to 35 mmHg in branches of splenic artery, it had decreased 133 mmHg before and after embolization. Conclusion : Interventional embolization of main trunk of the splenic artery can obviously short the bleeding time of splenic rupture, it is a novel, effective and minimally invasive means for treatment of grade II ~IV splenic rupture, will not result in splenic infarcation.