<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT02261584</url>
  </required_header>
  <id_info>
    <org_study_id>Microwave vs PSE</org_study_id>
    <nct_id>NCT02261584</nct_id>
  </id_info>
  <brief_title>Microwave Ablation and Partial Splenic Embolization in the Management of Hypersplenism</brief_title>
  <official_title>Comparative Study of Microwave Ablation and Partial Splenic Embolization in the Management of Hypersplenism</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Tanta University</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Tanta University</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
  </oversight_info>
  <brief_summary>
    <textblock>
      The aim of this study is to compare microwave thermal coagulation and partial splenic&#xD;
      embolization in the management of hypersplenism in patients with cirrhosis.&#xD;
&#xD;
      This study will be conducted on 40 patients with liver cirrhosis associated with splenomegaly&#xD;
      and hypersplenism. The study will be done at the National Hepatology and Tropical Medicine&#xD;
      Research Institute.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Liver cirrhosis or portal hypertension is frequently associated with congestive splenomegaly&#xD;
      resulting in hypersplenism.&#xD;
&#xD;
      Hypersplenism can be defined as anemia, leukopenia, thrombocytopenia, or a combination of&#xD;
      these resulting from excessive, splenic sequestration or pooling of blood cells, usually&#xD;
      associated with clinical splenomegaly and always ameliorated by splenectomy.&#xD;
&#xD;
      Partial splenic embolization (PSE), which was first performed by Spigos et al in 1979, has&#xD;
      been considered first-line therapy for hypersplenism in many institutions, and has been&#xD;
      proposed as an effective alternative to splenectomy for improving peripheral blood cell&#xD;
      counts. However, PSE is associated with many complications, including intermittent fever,&#xD;
      abdominal pain, nausea, vomiting, post-embolization syndrome, splenic abscess, splenic&#xD;
      rupture, pneumonia, refractory ascites, pleural effusion and gastrointestinal bleeding. To&#xD;
      ensure a sustained and long-term increase in platelet and leucocytic counts, the splenic&#xD;
      infarction rate needs to be greater than 50%. Thus, severe complications can ensue.&#xD;
&#xD;
      Thermal ablation methods using different energy sources, such as radiofrequency (RF),&#xD;
      microwave (MW), or laser, were developed rapidly as minimally invasive techniques for the&#xD;
      eradication of local tumor tissue within solid organs. There have been reports of the use of&#xD;
      radiofrequency to ablate normal spleen, splenic injury, and splenomegaly.&#xD;
&#xD;
      Radiofrequency Ablation (RFA) had comparable efficacy and a better safety than PSE in the&#xD;
      treatment of hypersplenism in patients with post hepatitis c cirrhosis.&#xD;
&#xD;
      MW ablation performed either laparoscopically or percutaneously is a safe, effective, and&#xD;
      minimally invasive technique for the management of hypersplenism in patients with liver&#xD;
      cirrhosis. It may significantly increase platelet count and white blood cells (WBC) count and&#xD;
      improve hepatic blood supply with fewer complications. Ablating more than 40% of the splenic&#xD;
      parenchyma may yield better long term results. This method may provide a new and promising&#xD;
      minimally invasive alternative for treating hypersplenism.&#xD;
&#xD;
      The aim of this study is to compare microwave thermal coagulation and partial splenic&#xD;
      embolization in the management of hypersplenism in patients with cirrhosis.&#xD;
&#xD;
      This study will be conducted on 40 patients with liver cirrhosis associated with splenomegaly&#xD;
      and hypersplenism. The study will be done at the National Hepatology and Tropical Medicine&#xD;
      Research Institute.&#xD;
&#xD;
      All patients will be subjected to thorough history taking, full clinical, lab,&#xD;
      ultrasound/doppler, and upper endoscopic examination. Diagnosis has been based on peripheral&#xD;
      blood count and confirmed with bone marrow examination.&#xD;
&#xD;
      Preoperative antibiotics will be given and correction of bleeding tendency with plasma and&#xD;
      platelet transfusion will be done as required to get a prothrombin concentration more than&#xD;
      65% and platelet count more than 100,000.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Unknown status</overall_status>
  <last_known_status>Recruiting</last_known_status>
  <start_date>August 2014</start_date>
  <completion_date type="Anticipated">February 2015</completion_date>
  <primary_completion_date type="Anticipated">February 2015</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Percentage of participants with improvement of hypersplenism after microwave thermal coagulation of the spleen compared with partial splenic embolization.</measure>
    <time_frame>6 months</time_frame>
  </primary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Anticipated">40</enrollment>
  <condition>Hypersplenism</condition>
  <arm_group>
    <arm_group_label>Microwave Thermal Coagulation</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>MW ablation performed either laparoscopically or percutaneously is a safe, effective, and minimally invasive technique for the management of hypersplenism in patients with liver cirrhosis. It may significantly increase platelet count and white blood cell (WBC) count and improve hepatic blood supply with fewer complications. Ablating more than 40% of the splenic parenchyma may yield better long term results. This method may provide a new and promising minimally invasive alternative for treating hypersplenism.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Partial Splenic Embolization Catheter</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Partial splenic embolization (PSE), which was first performed by Spigos et al in 1979, has been considered first-line therapy for hypersplenism in many institutions, and has been proposed as an effective alternative to splenectomy for improving peripheral blood cell counts. However, PSE is associated with many complications, including intermittent fever, abdominal pain, nausea, vomiting, post-embolization syndrome, splenic abscess, splenic rupture, pneumonia, refractory ascites, pleural effusion and gastrointestinal bleeding. To ensure a sustained and long-term increase in platelet and leucocytic counts, the splenic infarction rate needs to be greater than 50% (8). Thus, severe complications can ensue.</description>
  </arm_group>
  <intervention>
    <intervention_type>Device</intervention_type>
    <intervention_name>Microwave Thermal Coagulation</intervention_name>
    <description>Microwave thermal coagulation of splenic parenchyma.</description>
    <arm_group_label>Microwave Thermal Coagulation</arm_group_label>
    <other_name>Microwave</other_name>
  </intervention>
  <intervention>
    <intervention_type>Device</intervention_type>
    <intervention_name>Partial Splenic Embolization</intervention_name>
    <description>Femoral artery approach will be used for splenic artery catheterization with the tip of the catheter always well advanced selectively into the splenic artery. Embolizing agent will be injected in small increments. Arteriography in between divided doses will be done to document the extent of devascularization.</description>
    <arm_group_label>Partial Splenic Embolization Catheter</arm_group_label>
    <other_name>PSE</other_name>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Liver Cirrhosis&#xD;
&#xD;
          -  Hypersplenism&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Patients with bad performance scale.&#xD;
&#xD;
          -  Patients with hepatic encephalopathy and tense ascites.&#xD;
&#xD;
          -  Patient with active esophageal variceal bleeding .&#xD;
&#xD;
          -  Patients with hypocellular bone marrow (BM).&#xD;
&#xD;
          -  Patients with renal failure.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>75 Years</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Asem A Elfert, MD</last_name>
    <role>Principal Investigator</role>
    <affiliation>Tanta Faculty of Medicine, Professor</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Fat-heya E Assel, MD'</last_name>
    <role>Study Director</role>
    <affiliation>Tanta Faculty of Medicine, Professor</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Mohamed M Elkassas</last_name>
    <role>Study Director</role>
    <affiliation>Dr.</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Islam S Ismail</last_name>
    <role>Study Director</role>
    <affiliation>Dr.</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Asem A Elfert, MD</last_name>
    <phone>+20-122-437-8188</phone>
    <email>asem1967@yahoo.com</email>
  </overall_contact>
  <location>
    <facility>
      <name>National Hepatology and Tropical Medicine Research Institute</name>
      <address>
        <city>Cairo</city>
        <country>Egypt</country>
      </address>
    </facility>
    <status>Recruiting</status>
    <contact>
      <last_name>Asem A Elfert, MD</last_name>
      <phone>+20-122-437-8188</phone>
      <email>asem1967@yahoo.com</email>
    </contact>
    <investigator>
      <last_name>Asem A Elfert, MD</last_name>
      <role>Principal Investigator</role>
    </investigator>
    <investigator>
      <last_name>Fat-heya E Assel, MD</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Mohamed M Elkassas</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Islam S Ismail</last_name>
      <role>Sub-Investigator</role>
    </investigator>
  </location>
  <location_countries>
    <country>Egypt</country>
  </location_countries>
  <results_reference>
    <citation>Pursnani KG, Sillin LF, Kaplan DS. Effect of transjugular intrahepatic portosystemic shunt on secondary hypersplenism. Am J Surg. 1997 Mar;173(3):169-73. doi: 10.1016/s0002-9610(97)00006-8.</citation>
    <PMID>9124620</PMID>
  </results_reference>
  <results_reference>
    <citation>Spigos DG, Jonasson O, Mozes M, Capek V. Partial splenic embolization in the treatment of hypersplenism. AJR Am J Roentgenol. 1979 May;132(5):777-82. doi: 10.2214/ajr.132.5.777.</citation>
    <PMID>107745</PMID>
  </results_reference>
  <results_reference>
    <citation>Tajiri T, Onda M, Yoshida H, Mamada Y, Taniai N, Kumazaki T. Long-term hematological and biochemical effects of partial splenic embolization in hepatic cirrhosis. Hepatogastroenterology. 2002 Sep-Oct;49(47):1445-8.</citation>
    <PMID>12239963</PMID>
  </results_reference>
  <results_reference>
    <citation>Sangro B, Bilbao I, Herrero I, Corella C, Longo J, Beloqui O, Ruiz J, Zozaya JM, Quiroga J, Prieto J. Partial splenic embolization for the treatment of hypersplenism in cirrhosis. Hepatology. 1993 Aug;18(2):309-14.</citation>
    <PMID>8340060</PMID>
  </results_reference>
  <results_reference>
    <citation>N'Kontchou G, Seror O, Bourcier V, Mohand D, Ajavon Y, Castera L, Grando-Lemaire V, Ganne-Carrie N, Sellier N, Trinchet JC, Beaugrand M. Partial splenic embolization in patients with cirrhosis: efficacy, tolerance and long-term outcome in 32 patients. Eur J Gastroenterol Hepatol. 2005 Feb;17(2):179-84. doi: 10.1097/00042737-200502000-00008.</citation>
    <PMID>15674095</PMID>
  </results_reference>
  <results_reference>
    <citation>Hayashi H, Beppu T, Okabe K, Masuda T, Okabe H, Baba H. Risk factors for complications after partial splenic embolization for liver cirrhosis. Br J Surg. 2008 Jun;95(6):744-50. doi: 10.1002/bjs.6081.</citation>
    <PMID>18412294</PMID>
  </results_reference>
  <results_reference>
    <citation>Zhu K, Meng X, Qian J, Huang M, Li Z, Guan S, Jiang Z, Shan H. Partial splenic embolization for hypersplenism in cirrhosis: a long-term outcome in 62 patients. Dig Liver Dis. 2009 Jun;41(6):411-6. doi: 10.1016/j.dld.2008.10.005. Epub 2008 Dec 12.</citation>
    <PMID>19070555</PMID>
  </results_reference>
  <results_reference>
    <citation>Matsuoka T, Yamamoto A, Okuma T, Oyama Y, Nakamura K, Inoue Y. CT-guided percutaneous radiofrequency ablation of spleen: a preliminary study. AJR Am J Roentgenol. 2007 Apr;188(4):1044-6. doi: 10.2214/AJR.06.0641.</citation>
    <PMID>17377043</PMID>
  </results_reference>
  <results_reference>
    <citation>Felekouras E, Kontos M, Pissanou T, Pikoulis E, Drakos E, Papalambros E, Diamantis T, Bastounis E. A new spleen-preserving technique using radiofrequency ablation technology. J Trauma. 2004 Dec;57(6):1225-9. doi: 10.1097/01.ta.0000145072.31725.52.</citation>
    <PMID>15625453</PMID>
  </results_reference>
  <results_reference>
    <citation>Liu Q, Ma K, He Z, Dong J, Hua X, Huang X, Qiao L. Radiofrequency ablation for hypersplenism in patients with liver cirrhosis: a pilot study. J Gastrointest Surg. 2005 May-Jun;9(5):648-57. doi: 10.1016/j.gassur.2004.11.006.</citation>
    <PMID>15862259</PMID>
  </results_reference>
  <results_reference>
    <citation>Wasfi et al., Prospective randomized controlled study of Radiofrequency Ablation and Partial Splenic Embolization in the Treatment of Hypersplenism in patients with post-hepatitis C cirrhosis. AASLD poster DDW 2014, Chicago, USA</citation>
  </results_reference>
  <results_reference>
    <citation>Liang P, Gao Y, Zhang H, Yu X, Wang Y, Duan Y, Shi W. Microwave ablation in the spleen for treatment of secondary hypersplenism: a preliminary study. AJR Am J Roentgenol. 2011 Mar;196(3):692-6. doi: 10.2214/AJR.10.4193.</citation>
    <PMID>21343515</PMID>
  </results_reference>
  <results_reference>
    <citation>Rasekhi AR, Naderifar M, Bagheri MH, Shahriari M, Foroutan H, Karimi M, Nabavizadeh SA. Radiofrequency ablation of the spleen in patients with thalassemia intermedia: a pilot study. AJR Am J Roentgenol. 2009 May;192(5):1425-9. doi: 10.2214/AJR.08.1382.</citation>
    <PMID>19380572</PMID>
  </results_reference>
  <results_reference>
    <citation>Crooks V, Waller S, Smith T, Hahn TJ. The use of the Karnofsky Performance Scale in determining outcomes and risk in geriatric outpatients. J Gerontol. 1991 Jul;46(4):M139-44. doi: 10.1093/geronj/46.4.m139.</citation>
    <PMID>2071835</PMID>
  </results_reference>
  <verification_date>October 2014</verification_date>
  <study_first_submitted>September 26, 2014</study_first_submitted>
  <study_first_submitted_qc>October 9, 2014</study_first_submitted_qc>
  <study_first_posted type="Estimate">October 10, 2014</study_first_posted>
  <last_update_submitted>October 9, 2014</last_update_submitted>
  <last_update_submitted_qc>October 9, 2014</last_update_submitted_qc>
  <last_update_posted type="Estimate">October 10, 2014</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Tanta University</investigator_affiliation>
    <investigator_full_name>Ibrahim Shebl</investigator_full_name>
    <investigator_title>Dr.</investigator_title>
  </responsible_party>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Hypersplenism</mesh_term>
  </condition_browse>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT02261584
org study id: Microwave vs PSE
nct id: NCT02261584
lead sponsor: 
has dmc: Yes
The aim of this study is to compare microwave thermal coagulation and partial splenic
      embolization in the management of hypersplenism in patients with cirrhosis.

      This study will be conducted on 40 patients with liver cirrhosis associated with splenomegaly
      and hypersplenism. The study will be done at the National Hepatology and Tropical Medicine
      Research Institute.
Liver cirrhosis or portal hypertension is frequently associated with congestive splenomegaly
      resulting in hypersplenism.

      Hypersplenism can be defined as anemia, leukopenia, thrombocytopenia, or a combination of
      these resulting from excessive, splenic sequestration or pooling of blood cells, usually
      associated with clinical splenomegaly and always ameliorated by splenectomy.

      Partial splenic embolization (PSE), which was first performed by Spigos et al in 1979, has
      been considered first-line therapy for hypersplenism in many institutions, and has been
      proposed as an effective alternative to splenectomy for improving peripheral blood cell
      counts. However, PSE is associated with many complications, including intermittent fever,
      abdominal pain, nausea, vomiting, post-embolization syndrome, splenic abscess, splenic
      rupture, pneumonia, refractory ascites, pleural effusion and gastrointestinal bleeding. To
      ensure a sustained and long-term increase in platelet and leucocytic counts, the splenic
      infarction rate needs to be greater than 50%. Thus, severe complications can ensue.

      Thermal ablation methods using different energy sources, such as radiofrequency (RF),
      microwave (MW), or laser, were developed rapidly as minimally invasive techniques for the
      eradication of local tumor tissue within solid organs. There have been reports of the use of
      radiofrequency to ablate normal spleen, splenic injury, and splenomegaly.

      Radiofrequency Ablation (RFA) had comparable efficacy and a better safety than PSE in the
      treatment of hypersplenism in patients with post hepatitis c cirrhosis.

      MW ablation performed either laparoscopically or percutaneously is a safe, effective, and
      minimally invasive technique for the management of hypersplenism in patients with liver
      cirrhosis. It may significantly increase platelet count and white blood cells (WBC) count and
      improve hepatic blood supply with fewer complications. Ablating more than 40% of the splenic
      parenchyma may yield better long term results. This method may provide a new and promising
      minimally invasive alternative for treating hypersplenism.

      The aim of this study is to compare microwave thermal coagulation and partial splenic
      embolization in the management of hypersplenism in patients with cirrhosis.

      This study will be conducted on 40 patients with liver cirrhosis associated with splenomegaly
      and hypersplenism. The study will be done at the National Hepatology and Tropical Medicine
      Research Institute.

      All patients will be subjected to thorough history taking, full clinical, lab,
      ultrasound/doppler, and upper endoscopic examination. Diagnosis has been based on peripheral
      blood count and confirmed with bone marrow examination.

      Preoperative antibiotics will be given and correction of bleeding tendency with plasma and
      platelet transfusion will be done as required to get a prothrombin concentration more than
      65% and platelet count more than 100,000.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Treatment
masking: None (Open Label)
measure: Percentage of participants with improvement of hypersplenism after microwave thermal coagulation of the spleen compared with partial splenic embolization.
time frame: 6 months
arm group label: Microwave Thermal Coagulation
arm group type: Experimental
description: MW ablation performed either laparoscopically or percutaneously is a safe, effective, and minimally invasive technique for the management of hypersplenism in patients with liver cirrhosis. It may significantly increase platelet count and white blood cell (WBC) count and improve hepatic blood supply with fewer complications. Ablating more than 40% of the splenic parenchyma may yield better long term results. This method may provide a new and promising minimally invasive alternative for treating hypersplenism.
arm group label: Partial Splenic Embolization Catheter
arm group type: Experimental
description: Partial splenic embolization (PSE), which was first performed by Spigos et al in 1979, has been considered first-line therapy for hypersplenism in many institutions, and has been proposed as an effective alternative to splenectomy for improving peripheral blood cell counts. However, PSE is associated with many complications, including intermittent fever, abdominal pain, nausea, vomiting, post-embolization syndrome, splenic abscess, splenic rupture, pneumonia, refractory ascites, pleural effusion and gastrointestinal bleeding. To ensure a sustained and long-term increase in platelet and leucocytic counts, the splenic infarction rate needs to be greater than 50% (8). Thus, severe complications can ensue.
intervention type: Device
intervention name: Microwave Thermal Coagulation
description: Microwave thermal coagulation of splenic parenchyma.
arm group label: Microwave Thermal Coagulation
other name: Microwave
intervention type: Device
intervention name: Partial Splenic Embolization
description: Femoral artery approach will be used for splenic artery catheterization with the tip of the catheter always well advanced selectively into the splenic artery. Embolizing agent will be injected in small increments. Arteriography in between divided doses will be done to document the extent of devascularization.
arm group label: Partial Splenic Embolization Catheter
other name: PSE
criteria: 
gender: All
minimum age: 18 Years
maximum age: 75 Years
healthy volunteers: No
last name: Asem A Elfert, MD
role: Principal Investigator
affiliation: Tanta Faculty of Medicine, Professor
last name: Fat-heya E Assel, MD'
role: Study Director
affiliation: Tanta Faculty of Medicine, Professor
last name: Mohamed M Elkassas
role: Study Director
affiliation: Dr.
last name: Islam S Ismail
role: Study Director
affiliation: Dr.
last name: Asem A Elfert, MD
phone: +20-122-437-8188
email: asem1967@yahoo.com
facility: 
status: Recruiting
contact: 
investigator: 
investigator: 
investigator: 
investigator: 
country: Egypt
citation: Pursnani KG, Sillin LF, Kaplan DS. Effect of transjugular intrahepatic portosystemic shunt on secondary hypersplenism. Am J Surg. 1997 Mar;173(3):169-73. doi: 10.1016/s0002-9610(97)00006-8.
PMID: 9124620
citation: Spigos DG, Jonasson O, Mozes M, Capek V. Partial splenic embolization in the treatment of hypersplenism. AJR Am J Roentgenol. 1979 May;132(5):777-82. doi: 10.2214/ajr.132.5.777.
PMID: 107745
citation: Tajiri T, Onda M, Yoshida H, Mamada Y, Taniai N, Kumazaki T. Long-term hematological and biochemical effects of partial splenic embolization in hepatic cirrhosis. Hepatogastroenterology. 2002 Sep-Oct;49(47):1445-8.
PMID: 12239963
citation: Sangro B, Bilbao I, Herrero I, Corella C, Longo J, Beloqui O, Ruiz J, Zozaya JM, Quiroga J, Prieto J. Partial splenic embolization for the treatment of hypersplenism in cirrhosis. Hepatology. 1993 Aug;18(2):309-14.
PMID: 8340060
citation: N'Kontchou G, Seror O, Bourcier V, Mohand D, Ajavon Y, Castera L, Grando-Lemaire V, Ganne-Carrie N, Sellier N, Trinchet JC, Beaugrand M. Partial splenic embolization in patients with cirrhosis: efficacy, tolerance and long-term outcome in 32 patients. Eur J Gastroenterol Hepatol. 2005 Feb;17(2):179-84. doi: 10.1097/00042737-200502000-00008.
PMID: 15674095
citation: Hayashi H, Beppu T, Okabe K, Masuda T, Okabe H, Baba H. Risk factors for complications after partial splenic embolization for liver cirrhosis. Br J Surg. 2008 Jun;95(6):744-50. doi: 10.1002/bjs.6081.
PMID: 18412294
citation: Zhu K, Meng X, Qian J, Huang M, Li Z, Guan S, Jiang Z, Shan H. Partial splenic embolization for hypersplenism in cirrhosis: a long-term outcome in 62 patients. Dig Liver Dis. 2009 Jun;41(6):411-6. doi: 10.1016/j.dld.2008.10.005. Epub 2008 Dec 12.
PMID: 19070555
citation: Matsuoka T, Yamamoto A, Okuma T, Oyama Y, Nakamura K, Inoue Y. CT-guided percutaneous radiofrequency ablation of spleen: a preliminary study. AJR Am J Roentgenol. 2007 Apr;188(4):1044-6. doi: 10.2214/AJR.06.0641.
PMID: 17377043
citation: Felekouras E, Kontos M, Pissanou T, Pikoulis E, Drakos E, Papalambros E, Diamantis T, Bastounis E. A new spleen-preserving technique using radiofrequency ablation technology. J Trauma. 2004 Dec;57(6):1225-9. doi: 10.1097/01.ta.0000145072.31725.52.
PMID: 15625453
citation: Liu Q, Ma K, He Z, Dong J, Hua X, Huang X, Qiao L. Radiofrequency ablation for hypersplenism in patients with liver cirrhosis: a pilot study. J Gastrointest Surg. 2005 May-Jun;9(5):648-57. doi: 10.1016/j.gassur.2004.11.006.
PMID: 15862259
citation: Wasfi et al., Prospective randomized controlled study of Radiofrequency Ablation and Partial Splenic Embolization in the Treatment of Hypersplenism in patients with post-hepatitis C cirrhosis. AASLD poster DDW 2014, Chicago, USA
citation: Liang P, Gao Y, Zhang H, Yu X, Wang Y, Duan Y, Shi W. Microwave ablation in the spleen for treatment of secondary hypersplenism: a preliminary study. AJR Am J Roentgenol. 2011 Mar;196(3):692-6. doi: 10.2214/AJR.10.4193.
PMID: 21343515
citation: Rasekhi AR, Naderifar M, Bagheri MH, Shahriari M, Foroutan H, Karimi M, Nabavizadeh SA. Radiofrequency ablation of the spleen in patients with thalassemia intermedia: a pilot study. AJR Am J Roentgenol. 2009 May;192(5):1425-9. doi: 10.2214/AJR.08.1382.
PMID: 19380572
citation: Crooks V, Waller S, Smith T, Hahn TJ. The use of the Karnofsky Performance Scale in determining outcomes and risk in geriatric outpatients. J Gerontol. 1991 Jul;46(4):M139-44. doi: 10.1093/geronj/46.4.m139.
PMID: 2071835
responsible party type: Principal Investigator
investigator affiliation: Tanta University
investigator full name: Ibrahim Shebl
investigator title: Dr.
mesh term: Hypersplenism