Emergent Transcatheter Arterial Embolization in Hemodynamically Unstable Patients With Blunt Splenic Injury
| Autor: | Wu-Chung Shen, Hsein-Jar Chiang, Yung-Fang Chen, Yuan-Hong Tzeng, Chien-Heng Lin, Jeon-Hor Chen, Wei-Ching Lin, Yung-Jen Ho |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty Resuscitation medicine.medical_treatment Splenectomy Contrast Media Arteriovenous fistula Radiography Interventional Wounds Nonpenetrating Blunt splenic trauma Pseudoaneurysm Blunt medicine Humans Radiology Nuclear Medicine and imaging medicine.diagnostic_test business.industry Arterial Embolization Angiography Hemodynamics Prognosis medicine.disease Embolization Therapeutic Surgery Feasibility Studies Fluid Therapy Female Radiology Tomography X-Ray Computed business Spleen Extravasation of Diagnostic and Therapeutic Materials |
| Zdroj: | Academic Radiology. 15:201-208 |
| ISSN: | 1076-6332 |
| DOI: | 10.1016/j.acra.2007.09.010 |
| Popis: | Splenic preservation is currently the trend for treatment of patients with splenic trauma to avoid complications of splenectomy. This study aimed to evaluate the feasibility of emergent transcatheter arterial embolization (TAE) for hemodynamically unstable patients with blunt splenic injury.In a period of 2 years, 65 patients of blunt splenic trauma were studied. Patients with initial systolic blood pressure90 mmHg and showed initial response including rapid response and transient response to the emergent fluid resuscitation were included. Angiography and TAE was undertaken if contrast medium extravasation or pseudoaneurysm formation was noted in the computed tomography (CT) images, according to the criteria of American Association for the Surgery of Trauma. All patients who underwent TAE were admitted for observation of the possibility of delayed rupture.Thirteen hemodynamically unstable patients who were responsive to initial fluid resuscitation received angiography due to abnormal CT findings including contrast agent extravasation in 12 patients, 2 patients with arteriovenous fistula, and 8 patients with pseudoaneurysm formation. TAE was successfully performed in all of these 13 patients, including 2 patients with associated left renal injuries and 1 patient associated with bilateral internal mammary arteries injuries, without complications.TAE is a safe and effective procedure for treating blunt splenic injury even in hemodynamically unstable patients who responded to initial fluid resuscitation. |
| Databáze: | OpenAIRE |
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