Endovascular management of traumatic pseudoaneurysms
Abstract Background Pseudoaneurysms (PAs) caused by traumatic injury to the arterial vasculature have a high risk of rupture, leading to life-threatening hemorrhage and mortality, requiring urgent treatment. The purpose of this study was to determine the technical and clinical outcomes of endovascul...
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doaj-c9705f698b2a49339ab51d6fd2823a912020-11-29T12:21:20ZengSpringerOpenCVIR Endovascular2520-89342020-11-01311610.1186/s42155-020-00182-7Endovascular management of traumatic pseudoaneurysmsLauren Shreve0Maha Jarmakani1Hanna Javan2Ivan Babin3Kari Nelson4James Katrivesis5Michael Lekawa6Eric Kuncir7Dayantha Fernando8Nadine Abi-Jaoudeh9Department of Radiological Sciences, University of California, IrvineDepartment of Radiological Sciences, University of California, IrvineDepartment of Radiological Sciences, University of California, IrvineDepartment of Radiological Sciences, University of California, IrvineDepartment of Radiological Sciences, University of California, IrvineDepartment of Radiological Sciences, University of California, IrvineDepartment of Trauma Surgery, University of California, IrvineDepartment of Trauma Surgery, University of California, IrvineDepartment of Radiological Sciences, University of California, IrvineDepartment of Radiological Sciences, University of California, IrvineAbstract Background Pseudoaneurysms (PAs) caused by traumatic injury to the arterial vasculature have a high risk of rupture, leading to life-threatening hemorrhage and mortality, requiring urgent treatment. The purpose of this study was to determine the technical and clinical outcomes of endovascular treatment of visceral and extremity traumatic pseudoaneurysms. Methods Clinical data were retrospectively collected from all patients presenting for endovascular treatment of PAs between September 2012 and September 2018 at a single academic level one trauma center. Technical success was defined as successful treatment of the PA with no residual filling on post-embolization angiogram. Clinical success was defined as technical successful treatment with no rebleeding throughout the follow-up period and no reintervention for the PA. Results Thirty-five patients (10F/25M), average age (± stdev) 41.7 ± 20.1 years, presented with PAs secondary to blunt (n = 31) or penetrating (n = 4) trauma. Time from trauma to intervention ranged from 2 h - 75 days (median: 4.4 h, IQR: 3.5–17.1 h) with 27 (77%) of PAs identified and treated within 24 h of trauma. Average hospitalization was 13.78 ± 13.4 days. Ten patients underwent surgery prior to intervention. PA number per patient ranged from 1 to 5 (multiple diffuse). PAs were located on the splenic (n = 12, 34.3%), pelvic (n = 11, 31.4%), hepatic (n = 9, 25.7%), upper extremity/axilla (n = 2, 5.7%), and renal arteries (n = 1, 2.9%). Technical success was 85.7%. Clinical success was 71.4%, for technical failure (n = 5), repeat embolization (n = 1) or post-IR surgical intervention (n = 4). There was no PA rebleeding or reintervention for any patient after discharge over the reported follow-up periods. Three patients died during the trauma hospitalization for reasons unrelated to the PAs. Conclusions Endovascular treatment of traumatic visceral and extremity PAs is efficacious with minimal complication rates and low reintervention requirements.https://doi.org/10.1186/s42155-020-00182-7TraumaPseudoaneurysmEndovascular treatment |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Lauren Shreve Maha Jarmakani Hanna Javan Ivan Babin Kari Nelson James Katrivesis Michael Lekawa Eric Kuncir Dayantha Fernando Nadine Abi-Jaoudeh |
spellingShingle |
Lauren Shreve Maha Jarmakani Hanna Javan Ivan Babin Kari Nelson James Katrivesis Michael Lekawa Eric Kuncir Dayantha Fernando Nadine Abi-Jaoudeh Endovascular management of traumatic pseudoaneurysms CVIR Endovascular Trauma Pseudoaneurysm Endovascular treatment |
author_facet |
Lauren Shreve Maha Jarmakani Hanna Javan Ivan Babin Kari Nelson James Katrivesis Michael Lekawa Eric Kuncir Dayantha Fernando Nadine Abi-Jaoudeh |
author_sort |
Lauren Shreve |
title |
Endovascular management of traumatic pseudoaneurysms |
title_short |
Endovascular management of traumatic pseudoaneurysms |
title_full |
Endovascular management of traumatic pseudoaneurysms |
title_fullStr |
Endovascular management of traumatic pseudoaneurysms |
title_full_unstemmed |
Endovascular management of traumatic pseudoaneurysms |
title_sort |
endovascular management of traumatic pseudoaneurysms |
publisher |
SpringerOpen |
series |
CVIR Endovascular |
issn |
2520-8934 |
publishDate |
2020-11-01 |
description |
Abstract Background Pseudoaneurysms (PAs) caused by traumatic injury to the arterial vasculature have a high risk of rupture, leading to life-threatening hemorrhage and mortality, requiring urgent treatment. The purpose of this study was to determine the technical and clinical outcomes of endovascular treatment of visceral and extremity traumatic pseudoaneurysms. Methods Clinical data were retrospectively collected from all patients presenting for endovascular treatment of PAs between September 2012 and September 2018 at a single academic level one trauma center. Technical success was defined as successful treatment of the PA with no residual filling on post-embolization angiogram. Clinical success was defined as technical successful treatment with no rebleeding throughout the follow-up period and no reintervention for the PA. Results Thirty-five patients (10F/25M), average age (± stdev) 41.7 ± 20.1 years, presented with PAs secondary to blunt (n = 31) or penetrating (n = 4) trauma. Time from trauma to intervention ranged from 2 h - 75 days (median: 4.4 h, IQR: 3.5–17.1 h) with 27 (77%) of PAs identified and treated within 24 h of trauma. Average hospitalization was 13.78 ± 13.4 days. Ten patients underwent surgery prior to intervention. PA number per patient ranged from 1 to 5 (multiple diffuse). PAs were located on the splenic (n = 12, 34.3%), pelvic (n = 11, 31.4%), hepatic (n = 9, 25.7%), upper extremity/axilla (n = 2, 5.7%), and renal arteries (n = 1, 2.9%). Technical success was 85.7%. Clinical success was 71.4%, for technical failure (n = 5), repeat embolization (n = 1) or post-IR surgical intervention (n = 4). There was no PA rebleeding or reintervention for any patient after discharge over the reported follow-up periods. Three patients died during the trauma hospitalization for reasons unrelated to the PAs. Conclusions Endovascular treatment of traumatic visceral and extremity PAs is efficacious with minimal complication rates and low reintervention requirements. |
topic |
Trauma Pseudoaneurysm Endovascular treatment |
url |
https://doi.org/10.1186/s42155-020-00182-7 |
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