Splenic artery embolization with N-butyl cyanoacrylate in patients with blunt abdominal trauma

Introduction: Splenic artery embolization (SAE) has been shown to be safe and effective for non-operative management of patients with splenic trauma while preserving splenic function. A variety of coils, plugs, particles and liquid embolics have all been used. NBCA (n-butyl cyanoacrylate) is used less frequently than other modalities but is effective. Methods: A retrospective review of all patients who underwent SAE with NBCA for blunt abdominal trauma at a single tertiary medical center over a six-year period. Results: Out of 123 SAE patients, 7 utilized NBCA; 6 patients had intraparenchymal splenic artery pseudoaneurysms, 2 had intraparenchymal arteriovenous fistulas, and 5 had active extravasation from the spleen on CT imaging. There was 100% technical success rate. There were no acute post-op complications or complications at 30-day and 90-day follow up. One patient died 2 days following SAE secondary to worsening subdural hematoma unrelated to SAE. Conclusions: NBCA is safe and effective in treating patients with splenic injury particularly in patients with high grade splenic injury demonstrating extensive intraparenchymal vascular injury and/or intraprocedural extravasation in distal locations.