Enhancing Splenic Artery Embolization Outcomes with Patient-Specific Computational Fluid Dynamics*

Splenic artery embolization (SAE) has emerged as a minimally invasive solution for spleen injuries while maintaining organ function. Despite its growing popularity, the impact of hemodynamics during embolization is not fully understood. This study leverages patient-specific computational fluid dynamics (CFD) simulations to evaluate distal and proximal embolization techniques in SAE. We developed detailed 3D models encompassing the descending aorta, major visceral arteries, and iliac arteries. We then examined blood flow and pressure variations due to different coil placement strategies in proximal embolization, accounting for collateral vessels. Changes in pressure fields caused by coil placement were quantified and compared to baseline conditions, while flow stagnation was assessed using particle residence time. For distal embolization, we employed Lagrangian particle tracking to analyze the influence of particle size, release location, and timing on the embolization outcome. The findings emphasize the significant role of collateral vessels in preserving splenic blood supply post-proximal embolization. Coil placement affected distal pressure, and patient-specific CFD simulations can optimize coil positioning to achieve desired pressure reductions. Additionally, our results underscore the importance of particle size, release timing, and location in distal embolization. Our study represents an initial effort to use patient-specific modeling to refine SAE embolization.