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Partial splenic embolization with Glubran®2/Lipiodol® mixture for oncological patients with hypersplenism-related thrombocytopenia requiring systemic chemotherapy

   
@article{QIMS24644,
	author = {Romaric Loffroy and Nicolas Falvo and Motoki Nakaï and Lorenzo Pescatori and Serge Aho-Gléglé and Sophie Gehin and Pierre-Emmanuel Berthod and Romaric Né and Julie Vincent and François Ghiringhelli and Marco Midulla and Olivier Chevallier},
	title = {Partial splenic embolization with Glubran®2/Lipiodol® mixture for oncological patients with hypersplenism-related thrombocytopenia requiring systemic chemotherapy},
	journal = {Quantitative Imaging in Medicine and Surgery},
	volume = {9},
	number = {3},
	year = {2019},
	keywords = {},
	abstract = {Background: Partial splenic embolization (PSE) has been used to improve thrombocytopenia related to hypersplenism. The optimal embolic agent is still debated. The purpose of this study was to evaluate the safety, hematologic response and outcomes of PSE with cyanoacrylate glue for oncological patients with hypersplenism-related thrombocytopenia requiring systemic chemotherapy (SC).
Methods: Retrospective single-center observational report of cancer patients with thrombocytopenia related to hypersplenism and requiring SC who underwent PSE with N-butyl cyanoacrylate-methacryloxy sulfolane (NBCA-MS) Glubran®2 glue between February 2015 and September 2017. All patients were treated under local anesthesia with a Glubran®2/Lipiodol® mixture of 1:5 ratio. They all received empiric antibiotic coverage. Splenic volume and parenchyma infarction rate were evaluated by CT scan within 1 month of PSE. Primary and secondary endpoints of the current study included a platelet count increase >150×109/L and the initiation of SC, respectively. Periprocedural laboratory values and adverse events were recorded.
Results: PSE was performed in eight patients (6 males, 2 females; median age, 59 years; range, 33–75 years) for a technical success of 100%. For procedures with adequate follow-up, primary and secondary endpoints were achieved in 100% (7 of 7 patients) and 100% (7 of 7 patients) of patients, respectively. One patient died before follow-up, unrelated to the procedure. Mean splenic infarction post-PSE was 55% (range, 21–70%) on CT scan. For 7 patients with laboratory follow-up, the mean platelet count significantly increased from 74×109/L (range, 62–83) immediately before PSE to a peak level of 272×109/L (range, 161–417) 10 days after PSE (P},
	issn = {2223-4306},	url = {https://qims.amegroups.org/article/view/24644}
}