Portal de Periódicos da CAPES

Evaluation of the effect of partial splenic embolization on platelet values for liver cirrhosis patients with thrombocytopenia

2007; Baishideng Publishing Group; Volume: 13; Issue: 4 Linguagem: Inglês

10.3748/wjg.v13.i4.619

2219-2840

Chi‐Ming Lee, Ting‐Kai Leung, Hung Jung Wang, Wei Hsing Lee, Li Kuo Shen, Jean-Dean Liu, Chun Chao Chang, Ya Yen Chen,

Heparin-Induced Thrombocytopenia and Thrombosis

AIM:To investigate the effect of partial splenic embolization (PSE) on platelet values in liver cirrhosis patients with thrombocytopenia and to determine the effective embolization area for platelet values improvement.METHODS: Blood parameters and liver function indicators were measured on 10 liver cirrhosis patients (6 in Child-Pugh grade A and 4 in grade B) with thrombocytopenia (platelet values < 80 × 10 3 /μL) before embolization.Computed tomography scan was also needed in advance to acquire the splenic baseline.After 2 to 3 d, angiography and splenic embolization were performed.A second computed tomography scan was made to confirm the embolization area after 2 to 3 wk of embolization.The blood parameters of patients were also examined biweekly during the 1 year follow-up period. RESULTS:According to the computed tomography images after partial splenic embolization, we divided all patients into two groups: low (< 30%), and high (≥ 30%) embolization area groups.The platelet values were increased by 3 times compared to baseline levels after 2 wk of embolization in high embolization area group.In addition, there were significant differences in platelet values between low and high embolization area groups.GPT values decreased significantly in all patients after 2 wk of embolization.The improvement in platelet and GPT values still persisted until 1 year after PSE.In addition, 3 of 4 (75%) Child-Pugh grade B patients progressed to grade A after 2 mo of PSE.The complication rate in < 30% and ≥ 30% embolization area groups was 50% and 100%, respectively.CONCLUSION: Partial splenic embolization is an effective method to improve platelet values and GPT values in liver cirrhosis patients with thrombocytopenia and the ≥ 30% embolization area is meaningful for platelet values improvement.The relationship between the complication rate and embolization area needs further studies.