Long-term efficacy of partial splenic embolization for the treatment of steroid-resistant chronic immune thrombocytopenia

Thrombopoietin-receptor agonists have been recently introduced for a second-line treatment of immune thrombocytopenia (ITP). Splenectomy has tended to be avoided because of its complications, but the response rate of splenectomy is 60–80% and it has still been considered for steroid-refractory ITP. We performed partial splenic embolization (PSE) as an alternative to splenectomy. Between 1988 and 2013, 91 patients with steroid-resistant ITP underwent PSE at our hospital, and we retrospectively analyzed the efficacy and long-term outcomes of PSE. The complete response rate (CR, platelets > 100 × 10 9 /L) was 51% ( n = 46), and the overall response rate (CR plus response (R), > 30 × 10 9 /L) was 84% ( n = 76). One year after PSE, 70% of patients remained CR and R. The group with peak platelet count after PSE ≥ 300 × 10 9 /L ( n = 29) exhibited a significantly higher platelet count than the group with platelet count