To describe situations of major arterial injury caused by nonvascular intervention.
To describe indications of direct embolization via preexisting nonvascular route for major arterial injury.
To select proper technique for direct embolization in accordance with the size of injured artery and anatomical features.
Nonvascular intervention includes various interventions such as percutaneous needle biopsy, percutaneous transhepatic biliary intervention, percutaneous ablative treatments and others. In nonvascular intervention, arterial injury is one of the major complications [1, 2] (Figure 1), and transcatheter arterial embolization (TAE) may be required for major bleeding (Figure 2). Although conventional TAE via femoral, brachial or radial access is a basic technique to occlude the injured artery, it requires additional devices such as angiographic introducer, catheters (parent and micro), guidewires and others. Additionally, change in position of...
Findings and procedure details
Basic concept and features of direct embolization technique for injured artery
In direct embolization technique, injured artery is embolized through preexisting route of nonvascular intervention (Figure 3) such as percutaneous transhepatic biliary drainage (PTBD) route, percutaneous needle biopsy route or others. Therefore, conventional TAE can be curtailed (Figure 4-8). Embolization procedure can be initiated immediately following detection of arterial injury. Patients do not need change in their position. As embolic materials, gelatin sponge or coils are mainly used and they are selected depending on the...
Direct embolization techniques via preexisting nonvascular route for arterial injury is feasible, quickly available and can be an alternative to conventional TAE.
Personal information and conflict of interest
S. Sugawara; Chuo-ku, Tokyo/JP - nothing to disclose M. Sone; Tokyo/JP - nothing to disclose Y. Arai; Tokyo/JP - nothing to disclose M. Kusumoto; Chuo-ku/JP - nothing to disclose
1. Saad WE, Wallace MJ, Wojak JC et al. Quality improvement guidelines for percutaneous transhepatic cholangiography, biliary drainage, and percutaneous cholecystostomy. J Vasc Interv Radiol 2010; 21: 789-795.
2.Gupta S, Wallace MJ, Cardella JF et al. Quality improvement guidelines for percutaneous needle biopsy. J Vasc Interv Radiol 2010; 21: 969-975.
3.Angle JF, Siddiqi NH, Wallace MJ et al. Quality improvement guidelines for percutaneous transcatheter embolization: Society of Interventional Radiology Standards of Practice Committee. J Vasc Interv Radiol 2010; 21: 1479-1486.
4.Tamura M, Nakatsuka S, Shimizu...