Abstract
Advances in catheterization techniques have led to the broadening of the indications of splenic artery embolization. Although their indications are yet to be completely established in hematology, splenic embolizations are valuable as a programmed procedure in treating vulnerable patients affected by pseudoaneurysms, aneurysms, hypersplenism, as well as splenic traumas in an emergency setting.
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Appendices
Appendix: AAST Classification (Spleen) [1]
Gradea | Injury type | Injury description | AIS |
|---|---|---|---|
I | Hematoma | Subcapsular <10 % surface area | 2 |
Laceration | Capsular tear <1 cm parenchymal depth | 2 | |
II | Hematoma | Subcapsular, 10–50 % surface area; intraparenchymal, <5 cm in diameter | 2 |
Laceration | Capsular tear, 1–3 cm parenchymal depth that does not involve a trabecular vessel | 2 | |
III | Hematoma | Subcapsular, >50 % surface area or expanding; ruptured subcapsular or parenchymal hematoma; intraparenchymal hematoma ≥5 cm or expanding | 3 |
Laceration | >3 cm parenchymal depth or involving trabecular vessels | 3 | |
IV | Laceration | Laceration involving segmental or hilar vessels producing major devascularization (>25 % of the spleen) | 4 |
V | Hematoma | Completely shattered spleen | 5 |
Laceration | Hilar vascular lesions that devascularize spleen | 5 |
Appendix: “Baltimore” Classification of Spleen Traumas [4]
Grade | 1 | 2 | 3 | 4a | 4b |
|---|---|---|---|---|---|
Subcapsular hematoma | <1 cm | 1–3 cm | >3 cm | ||
Intraparenchymal hematoma | <1 cm | 1–3 cm | >3 cm | ||
Laceration | <1 cm | 1–3 cm | >3 cm | Shattered spleen | |
Other lesions | Capsular tear | Active intraparenchymal and subcapsular splenic bleeding, splenic vascular injury | Active intraperitoneal bleeding |
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Chabrot, P. et al. (2014). Splenic Arterial Embolizations. In: Chabrot, P., Boyer, L. (eds) Embolization. Springer, London. https://doi.org/10.1007/978-1-4471-5182-1_9
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DOI: https://doi.org/10.1007/978-1-4471-5182-1_9
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