Transarterial embolization to treat hemodynamically unstable trauma patients with splenic injuries: A retrospective multicenter observational study

•In this study, 38 patients with splenic injuries underwent emergency transarterial embolization (TAE).•Seventeen patients were hemodynamically unstable (HDU), and the other 21 patients were hemodynamically stable (HDS).•The survival discharge rate was 88.2 % (15/17) in the HDU patients and all HDS patients were discharged.•Rebleeding occurred in 23.5 % (4/17) of HDU patients compared to 4.8 % (1/21) of HDS patients; only one HDU patient required splenectomy.•The survival discharge rate of TAE for splenic trauma in HDU patients was acceptable with a low rate of splenectomy. We described clinical outcomes for patients with blunt splenic injuries treated with transarterial embolization (TAE) based on their hemodynamic status. This is a retrospective two-center study of adult patients with splenic injuries who underwent emergency TAE between January 2011 and December 2022. Patients were divided into two groups; hemodynamically unstable (HDU) and hemodynamically stable (HDS) patients. HDU patients were defined as transient- or non-responders to fluid resuscitation and HDS as responders. When immediate laparotomy was not possible for HDU patients, angiography and embolization were performed. The primary outcome was the survival discharge rate. Rebleeding and splenectomy rate was also investigated. Of 38 patients underwent emergency TAE for splenic trauma, 17 were HDU patients and 21 were HDS patients. The survival discharge rate was 88.2 % (15/17) in the HDU- and 100 % in HDS patients (p = 0.193). Rebleeding rate was 23.5 % (4/17) in HDU- and 5.0 % (1/21) in HDS patients (p = 0.15). Splenectomy was required for one HDU patient (5.9 %) for rebleeding. The survival discharge rate of TAE for splenic trauma in HDU patients was acceptable with a low rate of splenectomy. Further comparative studies of TAE versus operative management in HDU patients are needed to prove the usefulness of TAE.