James Shi1, Antoinette Gomes2, Edward Lee2, Stephen Kee2, John Moriarty2, Henry Cryer3, Justin McWilliams4. 1. Department of Radiology, UCLA Medical Center, Los Angeles, USA. 2. Department of Interventional Radiology, UCLA Medical Center, 757 Westwood Ave., Suite 2125C, Los Angeles, CA, 90095, USA. 3. Department of Surgery, UCLA Medical Center, Los Angeles, USA. 4. Department of Interventional Radiology, UCLA Medical Center, 757 Westwood Ave., Suite 2125C, Los Angeles, CA, 90095, USA. jumcwilliams@mednet.ucla.edu.
Abstract
PURPOSE: Transcatheter arterial embolization (TAE) is commonly used to control hemorrhage after pelvic trauma. Despite the procedures reported safety, there can be severe complications, mostly related to ischemia of embolized tissues. Our purpose was to examine the complications of trauma patients resulting from the embolization techniques utilized at our level 1 trauma center. MATERIALS AND METHODS: A retrospective chart review was conducted. One hundred and seven patients who underwent pelvic embolization between January 2003 and December 2013 were included. Patient demographics, ISS, angiography techniques, and major complications including gluteal and skin necrosis, wound breakdown, and deep infection were compared. RESULTS: Nine patients (8.4 %) developed major complications after undergoing TAE. This rate dropped to 5.1 % after exclusion of patients with Morel-Lavallee lesions. Nonselective embolization trended toward a higher complication rate compared to superselective embolization. Patients who developed complications were more likely to have undergone pelvic surgery. CONCLUSION: The majority of patients who developed complications had nonselective TAE. Morel-Lavallee lesions are a confounding factor, but TAE may impose an additional risk. Pelvic surgery after TAE may further predispose patients to complications. We recommend superselective embolization as first-line treatment and caution the use of prophylactic embolization, especially in patients with substantial pelvic soft tissue injuries.
PURPOSE: Transcatheter arterial embolization (TAE) is commonly used to control hemorrhage after pelvic trauma. Despite the procedures reported safety, there can be severe complications, mostly related to ischemia of embolized tissues. Our purpose was to examine the complications of traumapatients resulting from the embolization techniques utilized at our level 1 trauma center. MATERIALS AND METHODS: A retrospective chart review was conducted. One hundred and seven patients who underwent pelvic embolization between January 2003 and December 2013 were included. Patient demographics, ISS, angiography techniques, and major complications including gluteal and skin necrosis, wound breakdown, and deep infection were compared. RESULTS: Nine patients (8.4 %) developed major complications after undergoing TAE. This rate dropped to 5.1 % after exclusion of patients with Morel-Lavallee lesions. Nonselective embolization trended toward a higher complication rate compared to superselective embolization. Patients who developed complications were more likely to have undergone pelvic surgery. CONCLUSION: The majority of patients who developed complications had nonselective TAE. Morel-Lavallee lesions are a confounding factor, but TAE may impose an additional risk. Pelvic surgery after TAE may further predispose patients to complications. We recommend superselective embolization as first-line treatment and caution the use of prophylactic embolization, especially in patients with substantial pelvic soft tissue injuries.
Authors: Daniel C Cullinane; Henry J Schiller; Martin D Zielinski; Jaroslaw W Bilaniuk; Bryan R Collier; John Como; Michelle Holevar; Enrique A Sabater; S Andrew Sems; W Matthew Vassy; Julie L Wynne Journal: J Trauma Date: 2011-12
Authors: Vinu Perinjelil; Tareq Maraqa; Alex Chavez Yenter; Helen Ohaeri; Leo Mercer; Anish Bansal; Gul Sachwani-Daswani Journal: J Surg Case Rep Date: 2018-09-21