Background: Splenic artery embolization(SAE) has been an effective adjunct to the Non-operative management(NOM) for blunt splenic injury(BSI). However, the optimal embolization techniques are still inconclusive. To fu...Background: Splenic artery embolization(SAE) has been an effective adjunct to the Non-operative management(NOM) for blunt splenic injury(BSI). However, the optimal embolization techniques are still inconclusive. To further understand the roles of different embolization locations and embolic materials in SAE, we conducted this system review and meta-analyses.Methods: Clinical studies related to SAE for adult patients were researched in electronic databases, included Pub Med, Embase, Science Direct and Google Scholar Search(between October 1991 and March 2013), and relevant information was extracted. To eliminate the heterogeneity, a sensitivity analysis was conducted on two reduced study sets. Then, the pooled outcomes were compared and the quality assessments were performed using Newcastle-Ottawa Scale(NOS). The SAE success rate, incidences of life-threatening complications of different embolization techniques were compared by χ2 test in 1 st study set. Associations between different embolization techniques and clinical outcomes were evaluated by fixed-effects model in 2 nd study set.Results: Twenty-three studies were included in 1 st study set. And then, 13 of them were excluded, because lack of the necessary details of SAE. The remaining 10 studies comprised 2 nd study set, and quality assessments were performed using NOS. In 1 st set, the primary success rate is 90.1% and the incidence of life-threatening complications is 20.4%, though the cases which required surgical intervention are very few(6.4%). For different embolization locations, there was no obvious association between primary success rate and embolization location in both 1 st and 2 nd study sets(P >0.05). But in 2 nd study set, it indicated that proximal embolization reduced severe complications and complications needed surgical management. As for the embolic materials, the success rate between coil and gelfoam is not significant. However, coil is associated with a lower risk of life-threatening complications, as well as less complications requiring surgical management.Conclusion: Different embolization techniques affect the clinical outcomes of SAE. The proximal embolization is the best option due to the less life-threatening complications. For commonly embolic material, coil is superior to gelfoam for fewer severe complications and less further surgery management.展开更多
基金supported by grant from the Innovation Project of Military Medicine(No.16CXZ006)
文摘Background: Splenic artery embolization(SAE) has been an effective adjunct to the Non-operative management(NOM) for blunt splenic injury(BSI). However, the optimal embolization techniques are still inconclusive. To further understand the roles of different embolization locations and embolic materials in SAE, we conducted this system review and meta-analyses.Methods: Clinical studies related to SAE for adult patients were researched in electronic databases, included Pub Med, Embase, Science Direct and Google Scholar Search(between October 1991 and March 2013), and relevant information was extracted. To eliminate the heterogeneity, a sensitivity analysis was conducted on two reduced study sets. Then, the pooled outcomes were compared and the quality assessments were performed using Newcastle-Ottawa Scale(NOS). The SAE success rate, incidences of life-threatening complications of different embolization techniques were compared by χ2 test in 1 st study set. Associations between different embolization techniques and clinical outcomes were evaluated by fixed-effects model in 2 nd study set.Results: Twenty-three studies were included in 1 st study set. And then, 13 of them were excluded, because lack of the necessary details of SAE. The remaining 10 studies comprised 2 nd study set, and quality assessments were performed using NOS. In 1 st set, the primary success rate is 90.1% and the incidence of life-threatening complications is 20.4%, though the cases which required surgical intervention are very few(6.4%). For different embolization locations, there was no obvious association between primary success rate and embolization location in both 1 st and 2 nd study sets(P >0.05). But in 2 nd study set, it indicated that proximal embolization reduced severe complications and complications needed surgical management. As for the embolic materials, the success rate between coil and gelfoam is not significant. However, coil is associated with a lower risk of life-threatening complications, as well as less complications requiring surgical management.Conclusion: Different embolization techniques affect the clinical outcomes of SAE. The proximal embolization is the best option due to the less life-threatening complications. For commonly embolic material, coil is superior to gelfoam for fewer severe complications and less further surgery management.
