Partial Splenic Embolization

I spent 17 days in the hospital fighting ITP once again. With medications (IVIG, decadron,npate, retuxin), we were able to raise my platelet count from 5 to only a max of 12 - and no further improvements. My hematologist advised that I will reach a point where after several rounds of treatements, my body will start rejecting any medication. This, by the way is my fourth hospital stay. At this point (in my mind), I was ready for a splenectomy. However, after speaking to the radiologist and surgeon, I was advised of a Partial Splenic Arterial Embolization procedure.

Embolizing a Spleen partially means that the spleen will be reduced in size by selectively cutting of blood supply to certain areas. Thereby, decreasing the volume of platelets that the spleen is removing.

I thought it was a better option, so I agreed to the partial embolization. My daily platelet count after the procedure are as follows: 97, 68, 37, 72, 85, 123. I hope it starts going stable.

There is still a lot of pain as I am home now recovering. As the surgeon phrased it: "It hurts like hell since there is a part in you that is dying." Pain will continue until my spleen reaches its final size.

This is very interesting Ben! Thank you for posting- please keep us informed on your progress.

So are there side effects, dangers to this procedure- anything you have to be careful of? And your spleen still works to a lesser degree? And are you in the USA?

I haven't heard of this procedure but will look into it. Any more info would be interesting!

Good luck, hope you recover soon! Counts look good but yes stability is nice too.

Please keep us updated on your counts. I remember one person talking about this in the past 18 years, but don't know of anyone who has actually had it done. Usually, the understanding is that all splenic tissue must be removed or it won't work. People have had to have two or three subsequent surgeries to have splenic tissue removed that grew back, or have small accessory spleens removed because counts dropped.

I hope this works for you long-term.

@poseymint:
- As far as side effects that I am experiencing now... My heart rate is a little higher than normal. My resting heart rate used to be below 70, now it is just above 80. My blood pressure is also higher. It used to be around 120s/60s, no

Once again, I am back in the hospital. Since my original post, I had two more weekly CBC and the counts were 295 and 10. I am not responding much to medications or treatments anymore. The next step here is splenectomy. Wish me luck.

Best of luck Ben.

With this sort of procedure, is it odd to you that your counts aren't something between 295 and 10? Or, do they think the liver has taken over the platelet destruction business?

Hal,
Actually, from 295 to 10 in one week is a big drop, after it has been increasing since the Partial Embolization. My hematologist doesn't think that the liver has taken over. His opinion is just that I am no longer responding to medication. Even transfusions don't give me much increase anymore. I just had a transfusion, and I only went from 10 to 14. I used to get a bigger boost from transfusions.

Good luck, Ben. Please keep us updated.

(Since my last post) After all the medications were no longer working, I ended up having a splenectomy in January. The surgeon planned for lacroscopic splenectomy, but there were some complications, so woke up with open splenectomy being done. The complications were caused by the Partial Splenic Embolization procedure which had some leftover spleen that had to be fully removed. My pancreas was also damaged in the process. Oh well...
After leaving the hospital, I was back on my weekly CBC, then starting in May, my hematologist said I can just have a monthly CBC.
Platelet count was high (500+) after the day of the surgery, but went down to around 250 by the time I left the hospital. Since then it has been in a slow consistent decline. Every time I had a CBC, my platelet count has been lower than my previous test. Last week, I was at 149. My hematologist said it is still ok, but my concern is that my platelet count has been decreasing steadily, and at what point should I be worried.

All you can do is hope for the best and prepare for the worst. You might never get down to treatment level (under 30k) but if you do, you will deal with it. Remember that remissions are always possible.