Efficacy and clinical outcomes of proximal splenic artery embolization in patients with chemotherapy induced thrombocytopenia.

PURPOSE: This retrospective study aims to investigate efficacy and clinical outcomes of proximal splenic artery embolization (PSAE) in patients with chemotherapy induced thrombocytopenia (CIT). METHODS: PSAE was performed in thirteen patients with CIT (6:7, M:F; median age: 55y; range: 39-76y) with underlying malignancy (colorectal carcinoma: n = 6; pancreatic carcinoma: n = 3; other: n = 4). Median platelet counts were calculated prior to chemotherapy, at nadir resulting in chemotherapy discontinuation, prior to SAE, immediately and at the maximum following SAE. Additionally, the time until re-initiation of chemotherapy was calculated. RESULTS: Technical success was 100%, with no adverse events or 30-day mortality. Vascular plugs (n = 9) and coils (n = 11) were the most frequently used devices. Median platelet count pre-chemotherapy was 201 × 10(9)/L (range: 100-423 × 10(9)/L), platelet count nadir was 45 × 10(9)/L (range: 21-69 × 10(9)/L), and pre-SAE platelet count was 82 × 10(9)/L (range: 45-171 × 10(9)/L). After proximal SAE, median platelet count increased significantly (110 × 10(9)/L; range: 68-169 × 10(9)/L) compared to pre-procedure platelet count (p = 0.027). Median platelet count at the maximum at follow-up was 191 × 10(9)/L (range: 31-518 × 10(9)/L). Chemotherapy was re-initiated after a median of 15 days (range: 7-50d). CONCLUSION: Proximal SAE is a safe and effective treatment option in patients with CIT, with potential benefits in early re-initiation of chemotherapy. Further studies should be conducted to evaluate the longer-term effects of the procedure, further identify eligible patients, and compare to distal SAE.