Abstract
<jats:p>Objective. To evaluate the hematological effects and clinical efficacy of partial splenic artery embolization in the treatment of splenomegaly and hypersplenism in patients with portal hypertension caused by chronic liver diseases. Materials and Methods. A retrospective cohort study included 49 patients with chronic liver diseases of various etiologies. Spleen volume was determined using standardized ultrasound at the start of treatment and after 12 months; platelet counts were recorded, and the severity class was determined according to the Child–Pugh classification, along with the score on the Model for End-Stage Liver Disease (MELD) scale. All patients underwent combined distal and proximal splenic artery embolization. Results were evaluated based on absolute and relative changes in spleen volume, platelet count dynamics, and their correlation. Results. The mean spleen volume prior to partial splenic artery embolization was 975 cm³, and 12 months after the procedure, it was 605 cm³ (mean reduction: 36%). In contrast, the mean platelet count increased from 63.9 × 10⁹/L before surgery to 126.4 × 10⁹/L (+118%) 12 months later. The most pronounced hematological response was observed in patients with massive splenomegaly (organ volume exceeding 1000 cm³). A statistically significant moderate correlation was established between splenic volume reduction and the increase in platelet count (r = –0.53; p < 0.001). The use of 2D perfusion mapping confirmed the presence of marked splenic hyperperfusion in all patients prior to partial embolization of the splenic artery +3. Conclusions. Following partial embolization of the splenic artery, there is a consistent and clinically significant reduction in spleen volume with sustained correction of thrombocytopenia. The effect is most pronounced in cases of severe splenomegaly. Partial splenic artery embolization may serve as an effective organ-preserving alternative to splenectomy in the treatment of hypersplenism in portal hypertension.</jats:p>