Department of Vascular Neurosurgery, New Era Stroke Care and Research Institute, the General Hospital of the PLA Rocket Force, Beijing, China.
Department of Radiology, Beijing Jishuitan Hospital, Beijing, China.
Diagn Interv Radiol. 2019 May;25(3):219-224. doi: 10.5152/dir.2019.18212.
We aimed to study the technical and clinical outcome of urgent transcatheter arterial embolization (TAE) for postoperative arterial complications after pelvic or hip surgery, and to accumulate additional experience about the role of embolization for these injuries.
Patients who received TAE procedure for arterial complications after pelvic or hip surgery between September 1st, 2002 and December 1st, 2014 were screened on medical records and included in the analysis. Angiographic findings included active contrast agent extravasation, pseudoaneurysm formation, arteriovenous fistula, and other suspicious signs such as sighting of coarse margin or distortion of vessels. Embolic agents consisted of coils, gelatin sponge, and polyvinyl alcohol. Technical success was defined as complete occlusion of targeted artery through angiography, and clinical success as sustained resolution of symptoms.
A total of 22 patients (15 males, 19-76 years old) were enrolled. Prior to TAE, 12 patients developed hemorrhagic shock and the remaining 10 patients had hemorrhage-related pain, hematoma, or anemia. Contrast agent extravasation occurred in 12 cases, pseudoaneurysm formation in 5 cases, and other suspicious signs in 5 cases. Injury occurred in the internal iliac artery stem in 6 cases, inferior gluteal artery in 6 cases and superior gluteal artery in 6 cases. Multiple vascular lesions appeared in 5 cases. After TAE, technical success occurred in 22 patients and clinical success in 21 patients (95.5%). A 36-year-old woman died of irreversible multiple organ failure; no other severe procedure-related complications were recorded.
TAE is safe and effective for postoperative arterial complications after pelvic or hip surgery.
研究骨盆或髋关节手术后动脉并发症行紧急经导管动脉栓塞（TAE）的技术和临床效果，为这类损伤的栓塞治疗积累更多经验。
筛选 2002 年 9 月 1 日至 2014 年 12 月 1 日期间因骨盆或髋关节手术后动脉并发症行 TAE 治疗的患者，记录其病历资料并进行分析。血管造影发现包括：造影剂外渗、假性动脉瘤形成、动静脉瘘和其他可疑征象，如血管边缘粗糙或扭曲。栓塞剂包括弹簧圈、明胶海绵和聚乙烯醇。技术成功定义为通过血管造影完全闭塞目标动脉，临床成功定义为症状持续缓解。
共纳入 22 例患者（男 15 例，19-76 岁）。TAE 前，12 例患者发生失血性休克，其余 10 例患者有出血相关疼痛、血肿或贫血。12 例患者出现造影剂外渗，5 例患者出现假性动脉瘤形成，5 例患者出现其他可疑征象。6 例患者损伤发生于髂内动脉干，6 例患者损伤发生于臀下动脉，6 例患者损伤发生于臀上动脉。5 例患者出现多发血管病变。TAE 后，22 例患者技术成功，21 例患者临床成功（95.5%）。1 例 36 岁女性患者因多器官功能衰竭死亡，无其他严重与操作相关的并发症。
TAE 治疗骨盆或髋关节手术后动脉并发症安全有效。
