Splenic embolization revisited: a multicenter review
| Autor: | Kimberly A. Davis, Walter L. Biffl, James Haan, Thomas M. Scalea, M. Margaret Knudson, Sarah Majercik, Rochelle A. Dicker, Shelley R. Marder, Tomomi Oka |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Splenectomy Arteriovenous fistula Abdominal Injuries Critical Care and Intensive Care Medicine Wounds Nonpenetrating Blunt splenic trauma Aneurysm Trauma Centers Outcome Assessment Health Care medicine Humans Hemoperitoneum Embolization Treatment Failure Retrospective Studies Salvage Therapy Vascular disease business.industry Retrospective cohort study Splenic Rupture medicine.disease Embolization Therapeutic United States Surgery Radiography Treatment Outcome Arteriovenous Fistula Female Radiology medicine.symptom business Aneurysm False Spleen Extravasation of Diagnostic and Therapeutic Materials |
| Zdroj: | The Journal of trauma. 56(3) |
| ISSN: | 0022-5282 |
| Popis: | Background: Splenic embolization can increase nonoperative salvage. However, complications are not clearly defined. A retrospective multicenter review was performed to delineate the risks and benefits of splenic embolization. Methods: A retrospective chart review of all patients undergoing splenic embolization from 1997 to 2002 at four separate Level I trauma centers was performed. Reviewed results included patient demographics, admission and follow-up computed tomographic scan results, angiographic technique, and patient outcomes including splenic salvage rate and procedural complications. Results: A total of 140 patients were reviewed. The majority were young male patients involved in motor vehicle crashes. These patients had high abdominal computed tomographic grades of splenic injury and moderate Injury Severity Scores. The splenic salvage rate was 87%, which decreased with increasing injury grade. However, over 80% of splenic injury grades 4 and 5 were successfully managed nonoperatively. Significant hemoperitoneum did not affect success, but the presence of arteriovenous fistula was associated with a high failure rate, even with embolization. Salvage rates were similar between main coil and subselective embolization groups. Patients over 55 years of age did no worse than younger patients. Major complications included bleeding in 16 patients; 6 splenic abscesses, with 5 patients requiring splenectomy; and 1 episode of arterial injury requiring operative repair. Conclusion: Splenic embolization remains a valuable technique in splenic salvage, especially in higher grade injuries. Complications are common but do not seem to affect outcome. |
| Databáze: | OpenAIRE |
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