Partial Splenic Embolization

A minimally invasive treatment to reduce bleeding risk due to low platelets

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What is Partial Splenic Embolization?

The spleen fights infections and filters the blood to remove old or damaged cells. If the spleen grows large, it can become hyperactive. The most common cause is scarring of the liver (cirrhosis), which causes blood to back up in the spleen and make it grow. Other people have genetic or autoimmune conditions that affect their blood counts and spleen.

Platelets are a type of blood cell that forms blood clots to stop bleeding. When the spleen gets too big, it can filter out too many platelets, which can lead to bleeding. 

Partial splenic embolization is a minimally invasive procedure to block off some of the blood supply to the spleen to shrink it and make it less hyperactive.

How is Partial Splenic Embolization done?

You will be given medication to relax you. The skin on your wrist or top of the thigh will be cleaned and numbed. The clinician will slide a small tube through a pinhole in the skin into a blood vessel. X-rays and dye will guide them as they move the tube to the blood vessels supplying the spleen. They will inject special material like glue or soft metal coils through the tube to block off some of the blood vessels. They will remove the tube and apply a bandage over the pinhole in the skin.

Partial Splenic Embolization

1. After numbing the skin, the clinician uses x-rays to guide a small tube through a pinhole in the skin into the vessels feeding the spleen.

2. They block off some of the vessels feeding the spleen by filling them with special materials (beads shown).

3. After, they remove the tube and place a bandage over the pinhole in the skin. The spleen shrinks over time.

What are the risks?

Partial splenic embolization is generally a safe procedure when done by a specialist.

8 to 9 in 10 people experience

  • temporary upper abdominal pain 

  • nausea

  • fatigue

  • low-grade fever 

1 in 4 people have severe pain requiring strong painkillers such as morphine.

1 in 10 people develop

  • a buildup of fluid in the chest or belly

  • infection

  • blood clots

Death from the procedure is very rare.

Sometimes the procedure does not help the blood counts, or the spleen becomes hyperactive again over time. The likelihood of this happening depends on the specific cause of the abnormal blood counts. Talk to your clinician about the likelihood that this procedure could help you.

What are the alternatives?

Your treatment options depend on your preferences, overall health and unique conditions.

Alternative 1  No procedure avoids a procedure but your blood counts and bleeding risks are unlikely to improve and may get worse.

Alternative 2  Surgery to remove the spleen. This is often done for genetic conditions causing abnormal blood counts rather than scarring of the liver. People with scarring of the liver can get a liver transplant, which can help their blood counts. Surgery tends to have higher risk of complications with longer recovery than partial splenic embolization.

Alternative 3  TIPS. If the hyperactive spleen is caused by scarring of the liver, another option is creating a channel for blood to flow past the scarred liver. This decreases the backed up blood and can cause the spleen to grow less and to be less hyperactive.