Safety and efficacy of splenic artery coil embolization for hypersplenism in liver cirrhosis.

BACKGROUND: Partial splenic artery embolization is an effective treatment for hypersplenism but often lacks long-term benefits. PURPOSE: To evaluate the long-term effects of coil embolization of the splenic artery in patients with liver cirrhosis and hypersplenism. MATERIAL AND METHODS: Forty-nine patients with liver cirrhosis and hypersplenism underwent coil embolization of the main splenic artery. The coils were deployed in the mid- or distal segment of the splenic artery to allow collateral blood flow to the spleen. The following data were collected from 2 weeks to 4 years after the embolization: technical success, length of hospital stay, white blood cell count, platelet count, splenic volume, and complication. RESULTS: The technical success rate of splenic artery coil embolization was 100%. The post embolization syndrome rate was 75% (36/49) with no incidence of major complications. The mean length of hospital stay was 9 days. After embolization, the patient's white blood and platelet counts increased significantly, peaked at 2 weeks, and gradually decreased during the 4-year follow-up period, but remained at significantly higher levels than pre-embolization levels. Follow-up CT scans demonstrated a gradual increase in the volume of the enhanced portions of the spleens with a decrease in the volume of unenhanced portion. No significant changes occurred in the red blood cell count and liver function after the embolization. CONCLUSION: Embolization of the mid-and distal main splenic artery with coils is a safe and effective treatment of hypersplenism in cirrhosis with long-term hematologic benefits.

Comparison of total splenic artery embolization and partial splenic embolization for hypersplenism.

AIM: To evaluate whether total splenic artery embolization (TSAE) for patients with hypersplenism delivers better long-term outcomes than partial splenic embolization (PSE). METHODS: Sixty-one patients with hypersplenism eligible for TSAE (n = 27, group A) or PSE (n = 34, group B) were enrolled into the trial, which included clinical and computed tomography follow-up. Data on technical success, length of hospital stay, white blood cell (WBC) and platelet (PLT) counts, splenic volume and complications were collected at 2 wk, 6 mo, and 1, 2, 3, 4 years postoperatively. RESULTS: Both TSAE and PSE were technically successful in all patients. Complications were significantly fewer (P = 0.001), and hospital stay significantly shorter (P = 0.007), in group A than in group B. Post-procedure WBC and PLT counts in group A were significantly higher than those in group B from 6 mo to 4 years (P = 0.001), and post-procedure residual splenic volume in group A was significantly less than that observed in group B at 1, 2, 3 and 4 years post-procedure (P = 0.001). No significant differences were observed in red blood cell counts and liver function parameters between the two groups following the procedure. CONCLUSION: Our results indicate that TSAE for patients with hypersplenism not only delivers a better long-term outcome, but is also associated with lower complication rates and a shorter hospital stay than PSE.

[Studies on the infection status of seven species Mycoplasma, three species of Chlamydia, Neisseria gonorrhoeae and Garderella vaginalis in 76 patients with sexual transmitted diseases].

OBJECTIVE: To study the infectious status of seven species of Mycoplasma, three species of Chlamydia, Neisseria gonorrhoeae and Garderella vaginalis in the 76 male sexual transmitted disease (STD) patients in Yangzhou city. METHODS: Twelve species of pathogens including Ureaplasma urealyticum (Uu), Mycoplasma hominis (Mh), Mycoplasma pneumoniae (Mpn), Mycoplasma genitalium (Mg), Mycoplasma fermentans (Mf), Mycoplasma penetrans (Mpe), Mycoplasma prium (Mpi), Chlamydia trachomatis (Ct), Chlamydia pneumoniae (Cpn), Chlamydia psittaci (Cps), Neisseria gonorrhoeae (Ng) and Garderella vaginalis (GV) were detected by nested polymerase chain reaction including PPNG. RESULTS: The positive rates of Uu, Mh, Mpn, Mg, Mf, Mpe, Ct, Ng were 64.5%, 27.6%, 26.3%, 18.4%, 2.6%, 2.6%, 31.6%, 36.8%, in which Penicillinase-producing neisseria gonorrhoeae (PPNG) accounted for 14.3%, GV 15.8%. No Mpi, Cpn or Cps were found. There was more significant therapeutic effects on the detectable rate of Mycoplasma nucleic acid between positive gonococcus and negative gonococcus in male STDs patients (chi(2) = 3.848, P < 0.05). CONCLUSION: The infection rates of Mycoplasma, Chlamydia, Ng and GV were high among male STD patients in Yangzhou city. In clinical practice, more attention should be paid on correct diagnosis and treatment for patients, with Gonococcus, Chlamydia, Mycoplasma and GV.