Predictive factors of platelet increase and complications after percutaneous trans-arterial partial splenic embolization for hypersplenism in chronic liver disease patients

Purpose: To identify predictive factors for platelets normalization and major complications associated with partial splenic embolization (PSE) in patients with chronic liver disease and hypersplenism.Methods and materials: A prospective study included 30 patients were subjected to pre-embolization abdominal US and laboratory testing (WBC, Hemoglobin, Platelet Count, T. Bilirubin, AST, ALT, S. Albumin). PSE were done by super-selective catheterization of splenic artery and embolization by Polyvinyl alcohol with targeted therapeutic splenic infarction rate (>30% to <70–80%). CECT was performed before and 2 weeks after to assess complications (post embolization syndrome, ascites, peritonitis,pleural effusion, and splenic abscess) and infarction size. CBC, liver function tests was done after 2 weeks, 6 months. Platelet count done on the next day after the embolization.Results: Multiple logistic regression analysis showed that the infarction rate could be used as a predictor for platelets normalization (p value = 0.005, OR = 1.493). ROC curve showed that infarction rate above 76% had 100% specificity for platelets normalization after 6 months; infarction rate above 67% had 92.3% specificity. S. Albumin (2.7–3.2 mg/L), Child Score >8 remained significant predictors for major complication (p = 0.035).Conclusion: Platelet count normalization could be achieved by increasing infraction rate to 67–76%. Child Score and serum albumin are the predictive factor for complications