To compare intervention duration and fluoroscopy time for proximal embolization of splenic arteries in acute trauma using the Penumbra occlusion device (POD ^® ), coils or Amplatzer™ vascular plug (AVP).
A total of 29 patients with splenic injury without vascular injury who were treated by proximal splenic artery embolization using POD ^® (n=12), coils (n=9) or AVP (n=8) were retrospectively included. There were 25 men and 4 women with a median age of 34 years (range: 10-69 years). To overcome bias in treatment choice, a propensity score was used using inverse probability weighting. Intervention duration and fluoroscopy time, treatment success and complications were compared.
The median intervention duration was significantly shorter using POD ^® (30min) or AVP (47min) than using coils (60min) (P=0.0001 and 0.004, respectively). The median fluoroscopy time was significantly lower using POD ^® (11.5min) than using coils (23.6min) (P=0.0076) or AVP (16.5min) (P=0.049). The primary efficacy rate was 100% with POD ^® and AVP and 89% with coils (P=0.586). Six complications occurred with a mean follow-up of 12 months for POD ^® , 32 months for coils and 40 months for AVP, consisting in 2 abscesses treated by anti-biotherapy with POD ^® , one abscess with AVP, 2 material migrations with coils and 1 coil dismantled without consequence.
POD ^® and AVP allow proximal embolization of splenic artery in acute trauma with shorter intervention duration by comparison with conventional metallic coils with similar technical success. POD ^® allows a shorter fluoroscopy time than coils or AVP.