Percutaneous transcatheter embolization for arterial trauma.

With increasing technologic advances in interventional radiology, the vascular surgeon should be well versed in the indications, limitations, complications, and results of percutaneous transcatheter embolization for arterial trauma. Three hundred twenty-eight angiographically determined arterial injuries occurred in 242 patients from 1977 to 1984 in a major city hospital trauma center and were studied prospectively. Transcatheter embolizations performed for 107 arterial injuries in 100 patients were successful in 82.2% of injuries. Gelfoam, minicoils, microcoils, intimal dissections, or a combination of modalities was utilized. Anterior and posterior element pelvic fractures associated with hypotension and transfusion of 6 units or more of blood required embolization in 28 patients. Bleeding was controlled in 85.7% of patients. Percutaneous transcatheter embolization was also effective in controlling 84.2% of arteriovenous fistulas, 88.9% of penetrating neck arterial injuries, and 73.3% of postoperative intra-abdominal hemorrhage. Therapeutic transcatheter embolization is a valuable adjunct to the vascular surgeon dealing with the spectrum of vascular trauma.