# Splenic Embolization to Manage Thrombocytopenia in Cancer Patients: Case Reports and Review of the Literature

## TL;DR

This paper discusses using partial splenic embolization to treat low platelet counts in cancer patients to help them start or continue chemotherapy.

## Contribution

The paper presents two case reports and a literature review on the use of partial splenic embolization in managing cancer-related thrombocytopenia.

## Key findings

- One patient experienced improved platelet count after PSE but had a recurrence requiring repeat treatment.
- Another patient suffered severe complications from unintentional total embolization, preventing chemotherapy initiation.

## Abstract

Thrombocytopenia is a common complication of cancer and its management. Platelet count guides patients’ cancer treatment, as a safe threshold is required before initiating a chemotherapy regimen. Preventing thrombocytopenia in cancer patients is essential to avoid dose reduction or delay of chemotherapy. Partial splenic embolization (PSE) is a procedure that can increase platelet count in cancer patients, allowing them to initiate/resume chemotherapy and receive other treatments such as surgery and tumor ablation. Herein, we report two cases of cancer patients that underwent a PSE to improve thrombocytopenia in order to receive chemotherapy. One patient had a successful procedure, although they had a recurrence of thrombocytopenia 18 months later requiring repeat PSE. The other patient suffered serious complications as a result of unintentional total embolization of the spleen and the tail of the pancreas, resulting in necrotizing pancreatitis that rendered her unable to start chemotherapy. We analyzed both cases to provide insight on the safety and effectiveness of the procedure for cancer patients.