PARTIAL SPLENIC EMBOLIZATION FOR THE TREATMENT OF CHRONIC IDIOPATHIC THROMBOCYTOPENIC PURPURA

OBJECTIVE, The purpose of this study was to assess the effectiveness o f partial splenic embolization in the treatment of chronic idiopathic thrombocytopenic purpura. SUBJECTS AND METHODS. Twenty-six patients wi th chronic idiopathic thrombocytopenic purpura underwent partial splen ic embolization and were followed up for 6-61 months. The condition wa s refractory to steroids in 20 of 26 patients. The other six patients, in whom a response to steroids was shown, could not be withdrawn from steroid therapy because their platelet counts decreased with any decr ease in steroid dose. Five of 26 patients underwent splenectomy after partial splenic embolization, and the other patients were followed up without medical treatment until platelet counts decreased below 3 x 10 (10)/I. The therapeutic effect of partial splenic embolization was def ined on the basis of the platelet count at the last follow-up after pa rtial splenic embolization: complete response, greater than 10 x 10(10 )/I; partial response, 5 x 10(10)/I to 10 x 10(10)/I; and no response, less than 5 x 10(10)/I without medication. RESULTS. Partial splenic e mbolization brought a complete response in seven (33%) of 21 patients, a partial response in eight (38%), and no response in six (29%). In f our of five patients, who later underwent splenectomy, response to par tial splenic embolization was coincident with the response to splenect omy. No serious complications occurred, but minor complications such a s abdominal pain, fever, and nausea were observed in most patients. CO NCLUSION. This study suggests that partial splenic embolization might be useful as an alternative to splenectomy in the treatment of chronic idiopathic thrombocytopenic purpura.