Evidence map›Paper›PMID 39576386›Full record

SynthesisEmergency radiology2025

Splenic artery embolization for variceal bleeding in portal hypertension: a systematic review and metanalysis.

Mohadese Ahmadzade, Shahram Akhlaghpoor, Hamidreza Rouientan, Sara Hassanzadeh, Hamed Ghorani, Mahsa Heidari-Foroozan, Mobina Fathi, Fakhroddin Alemi, Shadi Nouri, Kelly Trinh and 2 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Emergency radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Mohadese AhmadzadeDepartment of Radiology, Division of Vascular and Interventional Radiology, Baylor College of Medicine, Houston, Texas, Houston, USA.
Shahram AkhlaghpoorDepartment of Interventional Radiology, Pardis Noor Medical Imaging and Cancer Center, Tehran, Iran, Tehran, Iran, Islamic Republic of.
Hamidreza RouientanDepartment of Interventional Radiology, Pardis Noor Medical Imaging and Cancer Center, Tehran, Iran, Tehran, Iran, Islamic Republic of.
Sara HassanzadehAdvanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of.
Hamed GhoraniAdvanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of.
Mahsa Heidari-ForoozanStudent Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Tehran, Iran, Islamic Republic of.
Mobina FathiStudent Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Tehran, Iran, Islamic Republic of.
Fakhroddin AlemiSchool of Medicine, Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of.
Shadi NouriDepartment of Radiology, Arak University of Medical Sciences, Arak, Iran, Arak, Iran, Islamic Republic of.
Kelly TrinhTexas Tech University Health Sciences Center, School of Medicine, Lubbock, Houston, USA.
Kei YamadaChief of Interventional Radiology Section, Tufts School of Medicine, Cambridge, MA, Boston, USA.
Mohammad Ghasemi-RadDepartment of Radiology, Division of Vascular and Interventional Radiology, Baylor College of Medicine, Houston, Texas, Houston, USA. mdghrad@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSplenic artery embolization (SAE) has emerged as a promising alternative for managing variceal bleeding secondary to portal hypertension (PH). This study aims to elucidate the significance of SAE in managing esophageal variceal bleeding in patients with PH, providing an overview of its efficacy, safety, and role in PH management.

methodsA systematic review and meta-analysis were conducted in accordance with PRISMA standards. EMBASE, PubMed, Scopus, and Web of Science databases were searched from inception until April 14, 2024. Original observational and clinical studies on SAE in managing variceal bleeding due to PH were included. Meta-analyses were performed using a random-effects model, and publication bias was assessed using regression and rank correlation tests for funnel plot asymmetry.

resultsEighteen studies met the inclusion criteria, encompassing 531 patients. The meta-analysis revealed a significant reduction in variceal bleeding post-SAE (RD = -0.86; 95% CI: -0.97, -0.75; p < 0.001). Complete resolution of varices was observed in 26% of patients (95% CI: 11%, 45%; p = 0.006), and 78% showed improvement in variceal grade (95% CI: 43%, 88%; p < 0.001). SAE significantly increased platelet counts (SMD = 1.15; 95% CI: 0.63, 1.68; p < 0.001). Common complications included post-embolization syndrome, and the overall complication rate was low.

conclusionsThis systematic review and meta-analysis study supports the efficacy and safety of SAE in managing variceal bleeding due to PH, demonstrating significant reductions in bleeding, improvements in variceal grade, and increases in platelet counts.

Indexed as

Embolization, TherapeuticEsophageal and Gastric VaricesGastrointestinal HemorrhageHypertension, PortalSplenic ArteryHumansInterventional radiologyMeta-analysisPortal hypertensionSplenic artery embolizationSystematic reviewVariceal bleeding

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.