Abstract：
This study aimed to assess the safety and efficacy of endovascular managements, including splenic vein recanalization (SVR), partial splenic embolization (PSE), and percutaneous transsplenic gastric varices embolization combined with PSE (PSE+GVE), for management of SPH-related variceal hemorrhage (VH).
A total of 61 patients with SPH-related VH from three hospitals were enrolled and classified into three groups: the SVR group (Group 1, n=24), the PSE+GVE group (Group 2, n=17), and the PSE group (Group 3, n=20). Baseline characteristics and clinical outcomes were compared among the groups.
The technical success rates for transhepatic and transsplenic SVR were 27.8% and 34.6%, respectively. No major complications were observed during any of the procedures. The median follow-up period was 53.2 months. The 2-year GI rebleeding rates for Group 1, 2, and 3 were 0%, 5.9%, and 35%, respectively. Groups 1 and 2 have a lower GI rebleeding rate (p = 0.002, p = 0.048, respectively) and better results of the degree of GV (p = 0.003, p = 0.044, respectively) compared to Group 3. No significant differences were found in 2-year GI rebleeding rates and the degree of GV between Group 1 and 2 (p = 0.415, p = 0.352, respectively).
SVR, PSE+GVE, and PSE seem safe and effective for management of SPH-related VH. SVR appears to be the superior treatment option. Transsplenic access may further increase the SVR success rate. PSE+GVE seems to have comparable outcomes in GV control and GI rebleeding rates compared to SVR, while superior to PSE.
A total of 61 patients with SPH-related VH from three hospitals were enrolled and classified into three groups: the SVR group (Group 1, n=24), the PSE+GVE group (Group 2, n=17), and the PSE group (Group 3, n=20). Baseline characteristics and clinical outcomes were compared among the groups.
The technical success rates for transhepatic and transsplenic SVR were 27.8% and 34.6%, respectively. No major complications were observed during any of the procedures. The median follow-up period was 53.2 months. The 2-year GI rebleeding rates for Group 1, 2, and 3 were 0%, 5.9%, and 35%, respectively. Groups 1 and 2 have a lower GI rebleeding rate (p = 0.002, p = 0.048, respectively) and better results of the degree of GV (p = 0.003, p = 0.044, respectively) compared to Group 3. No significant differences were found in 2-year GI rebleeding rates and the degree of GV between Group 1 and 2 (p = 0.415, p = 0.352, respectively).
SVR, PSE+GVE, and PSE seem safe and effective for management of SPH-related VH. SVR appears to be the superior treatment option. Transsplenic access may further increase the SVR success rate. PSE+GVE seems to have comparable outcomes in GV control and GI rebleeding rates compared to SVR, while superior to PSE.
摘要：
目的：本研究旨在评估血管内治疗的安全性和有效性，包括脾静脉再通（SVR），部分脾栓塞术(PSE),经皮经脾胃底静脉曲张栓塞联合PSE（PSE+GVE），用于SPH相关的静脉曲张出血（VH）的管理。
方法：纳入来自三家医院的61例SPH相关VH患者，分为三组：SVR组（第1组，n=24），PSE+GVE组（第2组，n=17），和PSE组(组3,n=20)。比较各组的基线特征和临床结果。
结果：经肝和脾SVR的技术成功率分别为27.8%和34.6%，分别。在任何手术期间均未观察到重大并发症。中位随访期为53.2个月。第1、2和3组的2年胃肠道再出血率为0%，5.9%，35%,分别。与第3组相比,第1组和第2组具有更低的GI再出血率(分别为p=0.002,p=0.048)和更好的GV程度结果(分别为p=0.003,p=0.044)。第1组和第2组的2年胃肠道再出血率和GV程度没有显着差异（分别为p=0.415，p=0.352）。
结论：SVR，PSE+GVE,PSE对于SPH相关VH的管理似乎是安全有效的。SVR似乎是更好的治疗选择。经脾入路可进一步提高SVR成功率。与SVR相比，PSE+GVE在GV控制和GI再出血率方面似乎具有可比性。而优于PSE。
方法：纳入来自三家医院的61例SPH相关VH患者，分为三组：SVR组（第1组，n=24），PSE+GVE组（第2组，n=17），和PSE组(组3,n=20)。比较各组的基线特征和临床结果。
结果：经肝和脾SVR的技术成功率分别为27.8%和34.6%，分别。在任何手术期间均未观察到重大并发症。中位随访期为53.2个月。第1、2和3组的2年胃肠道再出血率为0%，5.9%，35%,分别。与第3组相比,第1组和第2组具有更低的GI再出血率(分别为p=0.002,p=0.048)和更好的GV程度结果(分别为p=0.003,p=0.044)。第1组和第2组的2年胃肠道再出血率和GV程度没有显着差异（分别为p=0.415，p=0.352）。
结论：SVR，PSE+GVE,PSE对于SPH相关VH的管理似乎是安全有效的。SVR似乎是更好的治疗选择。经脾入路可进一步提高SVR成功率。与SVR相比，PSE+GVE在GV控制和GI再出血率方面似乎具有可比性。而优于PSE。
