J.Jpn. Surg. Soc.. 94(4): 383-393, 1993

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Original article

LONG-TERM PROGNOSIS OF IDIOPATHIC THROMBOCYTOPENIC PURPURA TREATED BY PARTIAL SPLENIC EMBOLIZATION

The therapeutic effect of partial splenic embolization (PSE) was evaluated in 13 patients with idiopathic thrombocytopenic purpura (ITP). Eight patients were treated by PSE and followed up over 6 months after the treatment. Two patients were treated by splenectomy following PSE.
(1) PSE achieved complete remission in one case, partial response in 3 cases, minimal response in one case and no change in 3 cases. PSE resulted in 62.5% of the effective rate. (2) The effect of PSE did not depend on age, sex, the duration of disease, platelet count and PA-IgG level before the treatment and the splenic infarcted rate. The platelet count after PSE increased more remarkably in the effective cases than in the non-effective ones (p＜0.01), which could predict the prognosis after PSE. (3) One patient whose platelet count increased enough after PSE had splenectomy later and resulted in complete remission. However another patient whose platelet count did not increase enough after PSE revealed no effect by splenectomy.
PSE for the treatment of ITP could prevent some patients from non-effective splenectomy and achieve the same effective rate as splenectomy. Therefore, PSE could be an alternative therapy of splenectomy because of the less invasive one.

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