Splenic Embolization to Manage Thrombocytopenia in Cancer Patients: Case Reports and Review of the Literature

脾栓塞治疗癌症患者血小板减少症:病例报告及文献综述

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Abstract

Thrombocytopenia is a common complication of cancer and its management. Platelet count guides patients' cancer treatment, as a safe threshold is required before initiating a chemotherapy regimen. Preventing thrombocytopenia in cancer patients is essential to avoid dose reduction or delay of chemotherapy. Partial splenic embolization (PSE) is a procedure that can increase platelet count in cancer patients, allowing them to initiate/resume chemotherapy and receive other treatments such as surgery and tumor ablation. Herein, we report two cases of cancer patients that underwent a PSE to improve thrombocytopenia in order to receive chemotherapy. One patient had a successful procedure, although they had a recurrence of thrombocytopenia 18 months later requiring repeat PSE. The other patient suffered serious complications as a result of unintentional total embolization of the spleen and the tail of the pancreas, resulting in necrotizing pancreatitis that rendered her unable to start chemotherapy. We analyzed both cases to provide insight on the safety and effectiveness of the procedure for cancer patients.

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