Title: Quantitative splenic embolization possible-Application of 8Spheres conformal
microspheres in partial splenic embolization(PSE)
Version: 0 Date: 02 Aug 2021
Reviewer:  Nobuo Waguri
Reviewer's report:
In this manuscript, the authors presented a very easy-to-understand study in which partial splenic
artery embolization with microspheres was performed in a unified manner in a large number of
cases to investigate the differences in the effects and complications depending on the diameter
of the microspheres. However, there are some problems to be confirmed.
Major comments
1. First, the cases are divided into two groups that are so neatly similar, and PSE is performed by
a unified method. The authors state that the shortcoming of this study is retrospective fashion,
but is it really a retrospective study?
Isn’t it a prospective controlled study?
2. As a PSE procedure, it is stated that the entire amount of 1 vial of microspheres was injected
from a microcatheter placed at the splenic hilum. However, the details of the injection procedure
are insufficient.
Minor comments
2-1. Most interventional radiologists usually perform embolization after selectively inserting a
microcatheter into the upper or lower pole branch of the splenic artery to clarify the area to be
embolized. We do not see the benefit of injecting embolic material throughout the spleen.
2-2. How is the microsphere diluted before injection? If the microspheres are not diluted
sufficiently, they will aggregate and embolize the proximal artery as large masses, and the
original size of the microspheres will not be utilized.
2-3. The microsphere injection must be performed so that it does not backflow from the tip of
the microcatheter. Can the authors always inject the entire volume of one microsphere vial?
2-3. Have the authors confirmed that microspheres flow from the peripheral branches of the
splenic artery to the branches that go out of the spleen (stomach, pancreas, omentum, etc.)?
Title: Quantitative splenic embolization possible-Application of 8Spheres conformal
microspheres in partial splenic embolization(PSE)
Version: 0 Date: 02 Aug 2021
Reviewer:  Nobuo Waguri
Reviewer's report:
In this manuscript, the authors presented a very easy-to-understand study in which partial splenic
artery embolization with microspheres was performed in a unified manner in a large number of
cases to investigate the differences in the effects and complications depending on the diameter
of the microspheres. However, there are some problems to be confirmed.
Major comments
1. First, the cases are divided into two groups that are so neatly similar, and PSE is performed by
a unified method. The authors state that the shortcoming of this study is retrospective fashion,
but is it really a retrospective study?
Isn’t it a prospective controlled study?
2. As a PSE procedure, it is stated that the entire amount of 1 vial of microspheres was injected
from a microcatheter placed at the splenic hilum. However, the details of the injection procedure
are insufficient.
Minor comments
2-1. Most interventional radiologists usually perform embolization after selectively inserting a
microcatheter into the upper or lower pole branch of the splenic artery to clarify the area to be
embolized. We do not see the benefit of injecting embolic material throughout the spleen.
2-2. How is the microsphere diluted before injection? If the microspheres are not diluted
sufficiently, they will aggregate and embolize the proximal artery as large masses, and the
original size of the microspheres will not be utilized.
2-3. The microsphere injection must be performed so that it does not backflow from the tip of
the microcatheter. Can the authors always inject the entire volume of one microsphere vial?
2-3. Have the authors confirmed that microspheres flow from the peripheral branches of the
splenic artery to the branches that go out of the spleen (stomach, pancreas, omentum, etc.)?
Please review this paper.
user
Title: Quantitative splenic embolization possible-Application of 8Spheres conformal
microspheres in partial splenic embolization(PSE)
Version: 0 Date: 02 Aug 2021
Reviewer:  Nobuo Waguri
Reviewer's report:
In this manuscript, the authors presented a very easy-to-understand study in which partial splenic
artery embolization with microspheres was performed in a unified manner in a large number of
cases to investigate the differences in the effects and complications depending on the diameter
of the microspheres. However, there are some problems to be confirmed.
Major comments
1. First, the cases are divided into two groups that are so neatly similar, and PSE is performed by
a unified method. The authors state that the shortcoming of this study is retrospective fashion,
but is it really a retrospective study?
Isn’t it a prospective controlled study?
2. As a PSE procedure, it is stated that the entire amount of 1 vial of microspheres was injected
from a microcatheter placed at the splenic hilum. However, the details of the injection procedure
are insufficient.
Minor comments
2-1. Most interventional radiologists usually perform embolization after selectively inserting a
microcatheter into the upper or lower pole branch of the splenic artery to clarify the area to be
embolized. We do not see the benefit of injecting embolic material throughout the spleen.
2-2. How is the microsphere diluted before injection? If the microspheres are not diluted
sufficiently, they will aggregate and embolize the proximal artery as large masses, and the
original size of the microspheres will not be utilized.
2-3. The microsphere injection must be performed so that it does not backflow from the tip of
the microcatheter. Can the authors always inject the entire volume of one microsphere vial?
2-3. Have the authors confirmed that microspheres flow from the peripheral branches of the
splenic artery to the branches that go out of the spleen (stomach, pancreas, omentum, etc.)?
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