Aims and objectives
To retrospectively evaluate our 11-year experience of TAE as a treatment for bleeding after hip surgery.
Methods and materials
We retrospectively evaluated 44 patients (M:F = 17:27; median age = 67.6 years) who underwent TAE in our Institution from 2006 to 2017.
Seventy percentof them underwent total hip arthroplasty,
20% open reduction internal fixation,
8% acetabular revision,
and 2% external fixation.
Preoperative multidetector computed tomography angiography (MDCTA) was used in 24 (53%) cases and showed arterial extravasation in 12 of them (50%).
Thirty-one TAEs (68.8%) were performed within a week from surgery; active hemorrhage was seen in 37 (82%) angiograms.
We used gelfoam,
microparticles,...
Results
Bleedings were stopped in all cases and were most frequently sustained from branches of the deep femoral artery (n = 19).
Permanent embolization agents (microparticles,
coils,
n-2-butyl-cyanoacrylate) were used in 84.5% of cases; temporary agents (gelfoam) in 13.5%; only once,
an endoprosthesis was deployed.
One procedure was complicated by dissection of a small artery without consequences.
Hospital discharge occurred on average 19 days post-TAE (range = 3-104 days; median = 16.5 days).
One-month survival rate was 97.7%: one patient died 3 days after TAE due...
Conclusion
In our experience TAE is safe and effective in stopping bleeding of the hip region and should be performed early,
to avoid irreversible ischemic damage.
MDCTA can be used to confirm bleeding in doubtful cases.
Several embolic materials can be used,
each one offering different advantages.
Low complication and mortality rates were observed.
Personal information
Authors:
Ezio Lanza1,
MD
Riccardo Muglia2, MD - corresponding author-
[email protected]
Marco Tramarin1,
MD
Dario Poretti1,
MD
Luca Balzarini1,
MD
Luigi Solbiati2,
Prof
Vittorio Pedicini1,
MD
1.
Humanitas Research Hospital
Department of Diagnostic and Interventional Radiology
Via A.
Manzoni 56 20089 Rozzano – Milano
tel.
0039 02 8224 7383 – fax.
0039 02 8224 6666
2.
Humanitas University
Residency program in Radiology
Via Rita Levi Montalcini 4,20090Pieve Emanuele – Milano
tel.
0039 02 8224 7383 – fax.
0039 02 8224 6666
References
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