الفهرس 
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Abstract
Hypersplenism is a clinical syndrome characterized by splenomegaly with variable combinations of anemia, leukopenia and thrombocytopenia. Hypersplenism may be seen in many disorders, but most commonly seen in cirrhotic liver with portal hypertension.
The use of splenic arterial embolization has been advocated for the intentional infarction of splenic tissue to reduce its consumptive activity.
Complete splenic infarction may produce severe complications, including splenic abscesses formation and other grave complications, such as rupture of the spleen, septicemia, and pneumonia, so partial splenic artery embolization is safer and better preserve the splenic immunological function. Partial splenic embolization when correctly performed is a safe and useful alternative to splenectomy with a resulting improvement of anemia, leukopenia and thrombocytopenia.
Partial splenic arterial embolization was performed by nonselective cannulation of the main splenic artery beyond the origin of major pancreatic branches and embolic particles were injected until (50-70 %) of the splenic parenchymal embolization was achieved. A second approach of partial selective embolization, in which a few distal branches of the splenic artery were selectively catheterized, and embolization was performed to achieve complete stasis in these branches while other branches are left untreated.
This study was carried out on thirty patients, presented with the manifestation of hypersplensim either secondary to chronic liver disease or idiopathic with the most distressing symptom was the bleeding tendency.
The embolizing materials used in our study were (Gelfoam, microspheres particles or PVA). Gelfoam pledgets were used in 20 patients and considered temporary occluding material. Permanent particles used with sizes ranged from 500 um to 700 um. Microspheres particles used in 5 patients while PVA used in 5 patients. In correlation with other studies, no significant post embolization differences in imaging findings among those patients with different types of embolizing materials.
Clinical assessment also had a big share in patient evaluation which indirectly reflected on the treatment outcome, passing from the liver status to splenic size. Adjuvant imaging tools like color Doppler ultrasonography also had a great impact in the assessment of porto-splenic circulation hemodynamics.
Platelets count was considered the corner stone for the patient’s selection and the main indication for the patients to seek medical advice. Platelets were the first corpuscular element to be corrected at the early post-embolization period and for us as indicator for technical success. Other corpuscular elements like RBCs and WBCs were also involved in diagnosis and correction of the hypersplenism, so they were monitored at both the pre and post-operative periods, they showed a substantial correction.