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Effects of transcatheter splenic arterial embolization on portal hypertensive gastric mucosa.

OBJECTIVES
The aim of this study was to address the effects of transcatheter splenic arterial embolization on portal hypertensive gastric mucosa.


METHODS
Thirty patients with portal hypertension and hypersplenism were included in this study. Seventeen patients underwent transcatheter splenic arterial embolization and 13 did not. The latter served as controls. Gastric mucosal hemodynamics was assessed by reflectance spectrophotometry which provides gastric mucosal hemoglobin content and oxygen saturation. Portal hypertensive gastropathy was also classified into three major categories (i.e., absent, mild, or severe). These examinations were performed before and 3 months after the procedure (i.e., splenic embolization or control).


RESULTS
Control had no significant changes on either gastric mucosal hemoglobin content or oxygen saturation. In contrast, splenic embolization induced a 11% reduction in gastric mucosal hemoglobin content (p < 0.01), although gastric mucosal oxygenation did not increase. Further, there was a significant difference in the rate of improvement of portal hypertensive gastropathy (splenic embolization vs. control; 71% vs. 8%, p < 0.05).


CONCLUSION
These results suggest that transcatheter splenic arterial embolization has a beneficial effect on portal hypertensive gastric mucosa in patients with hypersplenism.