Comparative Efficacy and Complication Rates of n-BCA Glue Partial Splenic Embolization in Patients with Varying Extent of Parenchymal Embolization

Non-traumatic partial splenic artery embolization (PSE) with n-butyl cyanoacrylate (nBCA) glue is a promising alternative to splenectomy. This study was done to compare the efficacy and complication rates of PSE with ≤70% and >70% splenic parenchymal embolization.

Materials and Methods:

We retrospectively analyzed all patients (2019-2024) who underwent non-traumatic nBCA PSE. Group A (n=10) had ≤70% embolization, and Group B (n=10) had >70%. Hematologic parameters were evaluated at 2 weeks, 1 month, and 1-year post-procedure and complication rates were recorded. Efficacy was measured by improvement in hematological parameters. Fisher’s exact test and t-test were used to compare the outcomes between the two groups.

Results:

Both groups had similar demographics (p >0.05), Child-Pugh (p=1), and MELD scores (p=0.97). Group A had an average infarction of 62.4%, and Group B had 96% (p< 0.001). Immunization rates (encapsulated organisms) were similar in both groups (p=0.69), and all 20 patients received peri-procedural broad-spectrum antibiotics.

The indications for PSE were similar between the 2 groups (p=0.82). Improvements in hematological parameters are shown in Table 1.

Most patients (n=19) were discharged within 24 hours of the procedure. One patient in group B had a prolonged hospital stay (7 days) due to non-target embolization leading to acute pancreatitis. All 20 patients had some degree of post-embolization syndrome, which was managed with analgesics.

Conclusion:

nBCA glue is effective for PSE, with low complication rates. There was no statistically significant difference between the two groups (≤70% and >70%) in terms of improvement in hematologic parameters. Further randomized control trials to compare and evaluate the longitudinal outcomes of varying extent of parenchymal embolization with nBCA glue will substantiate its utility in PSE.