Document Detail


Distal splenic artery hemodynamic changes during transient proximal splenic artery occlusion in blunt splenic injury patients: a mechanism of delayed splenic hemorrhage.
MedLine Citation:
PMID:  20571451     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Delayed splenic hemorrhage after proximal splenic artery embolotherapy (SAE) in patients with blunt splenic injury is a well-known outcome. The hemorrhage is thought to be due to rupture of a splenic parenchymal pseudoaneurysm. This study attempts to explain at least part of the mechanism involved in the delayed hemorrhage event.
METHODS: Hemodynamically stable patients with blunt splenic injury, without active extravasation, who underwent splenic artery angiography, also had the distal splenic artery pressure determined with transient balloon occlusion of the proximal splenic artery.
RESULTS: Seven patients were referred for splenic artery angiography. The average mean aortic pressure was found to be 89.0 ± 21.9 mm Hg. The average mean distal splenic arterial pressure with temporary proximal occlusion was 47.1 ± 25.8 mm Hg (range = 25-98 mm Hg). The average mean pressure drop was 41.9 ± 19.0 mm Hg or 48.0 ± 19.3%. The average systolic pressure drop was 75.4 ± 24.0 mm Hg (range = 40-113 mm Hg). However, one of our seven patients only had a 14.8% mean arterial pressure drop and maintained a 102 mm Hg systolic pressure in the distal splenic artery.
CONCLUSIONS: The arterial pressure in the distal splenic artery after SAE is highly variable and may depend on the robustness of pre-SAE collaterals.
Authors:
Jay A Requarth
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of trauma     Volume:  69     ISSN:  1529-8809     ISO Abbreviation:  J Trauma     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-15     Completed Date:  2011-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1423-6     Citation Subset:  AIM; IM    
Affiliation:
Section of Vascular and Interventional Radiology, Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina, USA. jrequart@wfubmc.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Angiography
Embolization, Therapeutic / adverse effects*
Hemodynamics / physiology*
Hemorrhage / etiology*,  physiopathology*,  radiography,  therapy*
Humans
Male
Middle Aged
Retrospective Studies
Spleen / blood supply,  injuries*,  radiography
Splenic Artery / injuries*,  physiopathology*,  radiography
Wounds, Nonpenetrating / physiopathology*,  radiography,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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