Transcatheter arterial embolization of the subclavian and axillary artery branches for hemorrhage control.

OBJECTIVE

To evaluate the effectiveness and safety of transcatheter arterial embolization (TAE) of the branches of the subclavian and axillary arteries for hemorrhage control.

METHODS

Between January 2015 and June 2022, 35 TAE procedures were performed for hemorrhage from the branches of the subclavian and axillary arteries in 34 patients (22 men, 12 women; 1 male underwent TAE twice; mean age = 76 years). Pre-TAE CT showed hematomas in the chest ( = 25) and abdominal walls ( = 3), shoulder ( = 2), and lower neck ( = 2). CT showed hemothorax in eight cases. Angiographic findings, embolization technique, and technical and clinical success of TAE were retrospectively assessed in all cases.

RESULTS

TAE was performed by transfemoral ( = 16), transradial ( = 12), and transbrachial ( = 7) approaches. Angiography revealed contrast media extravasation or pseudoaneurysms in 32 cases (91.4%). The most commonly embolized arteries were the internal thoracic ( = 12), lateral thoracic ( = 6), and thoracoacromial ( = 6) arteries. Technical and clinical success rates were 100 and 85.7%, respectively. A complication (skin necrosis after injection of the liquid embolic agent) developed in only one patient (2.9%) and was conservatively managed.

CONCLUSION

TAE is an effective and safe treatment for hemorrhage from the branches of the subclavian and axillary arteries.

ADVANCES IN KNOWLEDGE

Transfemoral approach has been used for TAE of the branches of the subclavian and axillary artery. Transradial and transbrachial approaches can also be considered.