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What Is Splenic Artery Embolization?

Splenic artery embolization is a minimally invasive endovascular procedure that intentionally reduces or stops blood flow through selected portions of the splenic arterial circulation. An interventional radiologist advances a catheter into the splenic artery and deploys coils, vascular plugs, particles, gelatin material, or other embolic agents according to the treatment goal. Proximal embolization decreases arterial pressure throughout the spleen while allowing collateral perfusion, whereas distal embolization selectively occludes injured or abnormal branches. The technique can control hemorrhage or reduce splenic perfusion while often preserving at least part of the spleen.

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What Is Splenic Artery Embolization?

Splenic artery embolization is a minimally invasive endovascular procedure that intentionally reduces or stops blood flow through selected portions of the splenic arterial circulation. An interventional radiologist advances a catheter into the splenic artery and deploys coils, vascular plugs, particles, gelatin material, or other embolic agents according to the treatment goal. Proximal embolization decreases arterial pressure throughout the spleen while allowing collateral perfusion, whereas distal embolization selectively occludes injured or abnormal branches. The technique can control hemorrhage or reduce splenic perfusion while often preserving at least part of the spleen.

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Why Is Splenic Artery Embolization Performed?

The most common modern indication is blunt splenic trauma in a hemodynamically stable patient with active arterial bleeding, a pseudoaneurysm, an arteriovenous fistula, or a high-grade injury at risk for failure of nonoperative management. Current trauma consensus recommendations support early embolization for stable adults with arterial contrast blush and generally favor angiography for high-grade injuries when expertise is available. The procedure is also used for selected splenic artery aneurysms or pseudoaneurysms, hypersplenism, portal-hypertension-related conditions, and other vascular or transplant-related problems. The embolization level and material are selected according to the disease, vessel anatomy, and amount of splenic tissue that should remain perfused.

How Is Splenic Artery Embolization Performed?

Arterial access is obtained through the groin or wrist, and a catheter is guided into the celiac and splenic arteries under fluoroscopy. Angiography identifies active bleeding, pseudoaneurysm, abnormal flow, or the arterial territory that needs treatment. Proximal embolization commonly uses coils or a vascular plug in the main splenic artery, while distal embolization uses a microcatheter to treat a specific branch closer to the injury or lesion. A completion angiogram confirms reduced or absent flow at the target while checking preservation of desired collateral circulation.

What Is Recovery Like After Splenic Artery Embolization?

Patients are observed after the procedure for recurrent bleeding, abdominal pain, fever, changes in blood counts, and complications at the arterial access site. Mild left-upper-abdominal pain, nausea, fatigue, or low-grade fever can occur as part of a postembolization response. Follow-up blood testing and imaging depend on the original indication, injury grade, amount of splenic infarction, and clinical course. Many trauma patients retain functional splenic tissue after embolization and avoid the long-term consequences associated with complete splenectomy.

What Are the Risks and Complications?

Possible complications include recurrent bleeding, splenic infarction, splenic abscess, access-site bleeding, contrast-related kidney injury, and coil or plug migration. Distal embolization can cause more segmental splenic infarction because individual peripheral branches are intentionally occluded. Rare complications include pancreatitis, arterial dissection, injury to adjacent vessels, or extensive loss of splenic tissue. Persistent hemorrhage or a major infected infarct can require repeat embolization, drainage, or splenectomy.

Frequently Asked Questions About Splenic Artery Embolization

What is the difference between proximal and distal splenic embolization?

Proximal embolization reduces pressure in the main splenic artery while preserving collateral flow, whereas distal embolization selectively blocks a specific injured or abnormal branch.

When is splenic artery embolization used after trauma?

It is commonly used in hemodynamically stable patients with arterial contrast blush, vascular injury, ongoing bleeding, or selected high-grade splenic injuries.

Does splenic artery embolization always destroy the spleen?

No. The technique is often designed to preserve functioning splenic tissue, especially when proximal or selective embolization can control bleeding without complete infarction.

What complications can occur after splenic embolization?

Recognized complications include rebleeding, splenic infarction, abscess, postembolization pain or fever, contrast injury, and uncommon migration of embolic material.

References

An Overview of Splenic Embolization. PubMed. https://pubmed.ncbi.nlm.nih.gov/26397320/. Date Accessed September 11, 2026.

Complications and failure rate of splenic artery angioembolization following blunt splenic trauma: A systematic review. PubMed. https://pubmed.ncbi.nlm.nih.gov/39111269/. Date Accessed September 11, 2026.

Follow-up strategies for patients with splenic trauma managed non-operatively: the 2022 World Society of Emergency Surgery consensus document. PubMed. https://pubmed.ncbi.nlm.nih.gov/36224617/. Date Accessed September 11, 2026.

Review of proximal splenic artery embolization in blunt abdominal trauma. PubMed. https://pubmed.ncbi.nlm.nih.gov/32026033/. Date Accessed September 11, 2026.

Splenic Artery Embolization: Tips, Tricks, and Current Standards of Practice. PubMed. https://pubmed.ncbi.nlm.nih.gov/41818131/. Date Accessed September 11, 2026.