Retrospective 12-Year Study of the Safety and Efficacy of Transcatheter Arterial Embolization for Managing Bleeding Complications Following Hip Surgery

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• 作者：Hongtao Cheng (1) (2)
  Ji Hoon Shin (1)
  Hyun Ki Yoon (1)
  Jooae Choe (1)
  Gi Young Ko (1)
  Dong Il Gwon (1)
  Heung Kyu Ko (1)
  Jin Hyoung Kim (1)
  Kyu Bo Sung (1)
  
• 关键词：Embolization ; Embolotherapy ; Fluoroscopy ; Intraarterial ; Transcatheter therapy ; Musculoskeletal ; Haemorrhage ; Hip joint ; Surgery
• 刊名：CardioVascular and Interventional Radiology
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：37
• 期：6
• 页码：1464-1468
• 全文大小：391 KB
• 参考文献：1. Halpern AA, Rinsky LJ, Burton DS (1977) Selective arterial embolization for hemorrhage following hip arthroplasty. Clin Orthop Relat Res 124:144-48
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  4. Chun HJ, Osuga K, Sugihara E et al (2010) Transarterial embolization of large complex arteriovenous fistula associated with hip joint surgery. Jpn J Radiol 28(6):489-92 CrossRef
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  11. Irisson E, Kerbaul F, Parratte S et al (2013) [Perioperative management based on kinetics of bleeding during total primary arthroplasty]. Ann Fr Anesth Reanim 32:170-74 CrossRef
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  13. Niola R, Pinto A, Sparano A et al (2012) Arterial bleeding in pelvic trauma: priorities in angiographic embolization. Curr Probl Diagn Radiol 41(3):93-01 CrossRef
  14. Romano L, Pinto A, Niola R et al (2012) Bleeding due to pelvic fractures in female patients: pictorial review of multidetector computed tomography imaging. Curr Probl Diagn Radiol 41(3):83-2 CrossRef
  15. Barriga A, Valenti Nin JR, Delgado C et al (2001) Therapeutic embolisation for postoperative haemorrhage after total arthroplasty of the hip and knee. J Bone Joint Surg Br 83(1):90-2 CrossRef
  16. Oppenheim WL, Harley JD, Lippert FG 3rd (1975) Arteriographic management of postoperative bleeding following major hip surgery. J Bone Joint Surg Am 57(1):126-28
  17. Mesa P, Portilla D, Carrasco MS et al (2009) Arterial embolization to control acute intraoperative bleeding. Rev Esp Anestesiol Reanim 56(4):268 CrossRef
  18. Sun PL, Lee YC, Chiu KC (2009) Retroperitoneal hemorrhage caused by enoxaparin-induced spontaneous lumbar artery bleeding and treated by tr
• 作者单位：Hongtao Cheng (1) (2)
  Ji Hoon Shin (1)
  Hyun Ki Yoon (1)
  Jooae Choe (1)
  Gi Young Ko (1)
  Dong Il Gwon (1)
  Heung Kyu Ko (1)
  Jin Hyoung Kim (1)
  Kyu Bo Sung (1)
  
  1. Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736, Korea
  2. Department of Interventional Radiology, The Affiliated Cancer Hospital of Zhengzhou University, No 127, Dongming Road, Zhengzhou, 450008, China
  
• ISSN：1432-086X

文摘

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.