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While balloon dilation is considered first-line therapy, further interventions such as stent placement or surgical revision are sometimes needed to treat these recalcitrant areas of stenosis. The purpose of this article is to define the role of splenic embolization in trauma patients and in patients presenting for treatment of thrombocytopenia and portal hypertension. This article reviews the indications, technical considerations, outcomes, and complications of splenic artery embolization. Transcatheter splenic artery embolizat