PURPOSE: This study was designed to evaluate the safety and effectiveness of transcatheter arterial embolization (TAE) for stopping bleeding following hip surgery. METHODS: We performed a 12-year retrospective analysis of 13 patients (M:F = 6:7, median age 72 years) who underwent angiography for bleeding following hip surgery. The types of surgery, latency time, angiographic findings, TAE details, procedure-related complications, and clinical outcomes were analyzed. Technical success was defined as no further bleeding detected on angiography following embolization. RESULTS: Total hip replacement arthroplasty was the most common surgery performed for these patients (n = 10). Seven of the 13 study patients underwent angiography the same day as their surgery. Angiograms showed active (n = 11) or suspicious (n = 1) bleeding in 12 of the 13 patients. Gelatin sponge particles, coils, NBCA, PVA, and their combinations were used as the embolic material. For the one patient without obvious signs of bleeding, prophylactic TAE was done to achieve bleeding control. For the 11 patients with active bleeding, 10 underwent technically successful TAE, and 1 patient underwent surgery due to a large pseudoaneurysm located near the bifurcation of the common femoral artery. There were no major procedure-related complications or patient mortality. The 30-day mortality rate was 15% (2/13), and both of these patients died of multiorgan failure. CONCLUSIONS: Transcatheter angiography is useful for identifying bleeding arteries. TAE is safe and effective for managing bleeding after hip surgery.
PURPOSE: This study was designed to evaluate the safety and effectiveness of transcatheter arterial embolization (TAE) for stopping bleeding following hip surgery. METHODS: We performed a 12-year retrospective analysis of 13 patients (M:F = 6:7, median age 72 years) who underwent angiography for bleeding following hip surgery. The types of surgery, latency time, angiographic findings, TAE details, procedure-related complications, and clinical outcomes were analyzed. Technical success was defined as no further bleeding detected on angiography following embolization. RESULTS: Total hip replacement arthroplasty was the most common surgery performed for these patients (n = 10). Seven of the 13 study patients underwent angiography the same day as their surgery. Angiograms showed active (n = 11) or suspicious (n = 1) bleeding in 12 of the 13 patients. Gelatin sponge particles, coils, NBCA, PVA, and their combinations were used as the embolic material. For the one patient without obvious signs of bleeding, prophylactic TAE was done to achieve bleeding control. For the 11 patients with active bleeding, 10 underwent technically successful TAE, and 1 patient underwent surgery due to a large pseudoaneurysm located near the bifurcation of the common femoral artery. There were no major procedure-related complications or patient mortality. The 30-day mortality rate was 15% (2/13), and both of these patients died of multiorgan failure. CONCLUSIONS: Transcatheter angiography is useful for identifying bleeding arteries. TAE is safe and effective for managing bleeding after hip surgery.
Authors: Pablo Ariel Slullitel; Lionel Llano; Christian García-Ávila; Fernando Diaz-Dilernia; Francisco Piccaluga; Martin Buttaro; Gerardo Zanotti; Fernando Comba Journal: Int Orthop Date: 2019-06-20 Impact factor: 3.075