Article ; Online: Transcatheter arterial embolization in abdominal blunt trauma with active mesenteric bleeding: case series and review of literature.
2020 Volume 28, Issue 1, Page(s) 55–63
Abstract: Purpose: To evaluate the safety and effectiveness of transcatheter arterial embolization (TAE) in treating traumatic mesenteric injuries with active bleeding, to report the outcome in a case series, and to compare the results with the existing data.: ... ...
| Abstract | Purpose: To evaluate the safety and effectiveness of transcatheter arterial embolization (TAE) in treating traumatic mesenteric injuries with active bleeding, to report the outcome in a case series, and to compare the results with the existing data. Methods: All consecutive patients with active mesenteric bleeding due to blunt abdominal trauma referred to a level-one Trauma Center and treated by TAE were included; the related demographic and medical data were retrospectively reported. A literature review was conducted; all reported cases were collected and analysed together with our case series. A univariate analysis of risk factors for TAE failure, bowel necrosis, complication and length of stay was performed. Results: Four consecutive patients were included. Technical success was 100%. One patient developed colon ischemia after the procedure and underwent surgical treatment; another presented transient mild renal failure and late respiratory failure. No 30-day mortality was reported. These results are consistent with those reported in literature. The analysis of our cases together with case collected from literature resulted in a case series of 25 patients. Univariate analysis showed colon as site of bleeding as a significant risk factor for bowel necrosis and older age as a significant risk factor for longer length of stay. TAE failure was not significantly associated neither with a higher complication rate nor with a higher length of stay. Conclusion: TAE is a safe and effective procedure to control mesenteric bleeding, thus should be considered, in selected cases and in appropriate setting, as an alternative to emergency surgery. |
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| MeSH term(s) | Abdominal Injuries/diagnostic imaging ; Abdominal Injuries/therapy ; Adult ; Aged ; Aged, 80 and over ; Computed Tomography Angiography ; Contrast Media ; Embolization, Therapeutic/methods ; Female ; Hemorrhage/therapy ; Humans ; Injury Severity Score ; Iohexol/analogs & derivatives ; Male ; Mesenteric Arteries/injuries ; Middle Aged ; Retrospective Studies ; Risk Factors ; Trauma Centers ; Treatment Failure ; Wounds, Nonpenetrating/diagnostic imaging ; Wounds, Nonpenetrating/therapy |
| Chemical Substances | Contrast Media ; iobitridol (182ECH14UH) ; Iohexol (4419T9MX03) |
| Language | English |
| Publishing date | 2020-07-28 |
| Publishing country | United States |
| Document type | Case Reports ; Journal Article ; Review |
| ZDB-ID | 1425144-9 |
| ISSN | 1438-1435 ; 1070-3004 |
| ISSN (online) | 1438-1435 |
| ISSN | 1070-3004 |
| DOI | 10.1007/s10140-020-01831-z |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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