Medium- and Long-Term Evaluation of Splenic Arterial Embolization: A Retrospective CT Volumetric and Hematologic Function Analysis.

Abstract

Background: Splenic arterial embolization (SAE) is a well-established technique in the non-operative management of splenic trauma and aneurysms. While its short-term safety and efficacy have been widely documented, medium- and long-term impacts on splenic volume and function remain under-investigated. This study aimed to evaluate volumetric changes and hematological parameters following SAE, with emphasis on its role in preserving splenic integrity and potential integration with AI-enhanced imaging technologies. Methods: We retrospectively analyzed 17 patients treated with SAE between January 2014 and December 2023. Volumetric measurements were performed using computed tomography (CT) with 3D reconstructions before and after SAE. Patients were divided into two groups based on indication: polytrauma (n = 8) and splenic artery aneurysm (n = 9). Hematological parameters including white blood cells (WBCs), red blood cells (RBCs), and hemoglobin (Hb) were evaluated in correlation with clinical outcomes. Statistical significance was assessed using Student's t-test, and power analysis was conducted. Results: Among the trauma group, mean splenic volume decreased from 190.5 ± 51.2 cm³ to 147.8 ± 77.8 cm³ (p = 0.2158), while in the aneurysm group, volume decreased from 195.4 ± 78.9 cm³ to 143.7 ± 81.4 cm³ (p = 0.184). Though not statistically significant, these changes suggest post-procedural splenic remodeling. The technical success of SAE was 100%, with no cases of late follow-up infarction, abscess, immunological impairment, or secondary splenectomy required. Hematologic parameters remained within normal limits in follow-up assessments. Conclusions: SAE represents a safe and effective intervention for spleen preservation in both traumatic and aneurysmal conditions. Although a reduction in splenic volume has been observed, white blood cell counts, a reliable indicator of splenic function, have remained stable over time. This finding supports the preservation of splenic function following SAE.