World Journal of Surgery

, Volume 24, Issue 5, pp 539–545

Angiographic Embolization for Intraperitoneal and Retroperitoneal Injuries

  • George C. Velmahos
  • Santiago Chahwan
  • Andres Falabella
  • Sue Ellen Hanks
  • Demetrios Demetriades
Article

DOI: 10.1007/s002689910087

Cite this article as:
Velmahos, G., Chahwan, S., Falabella, A. et al. World J. Surg. (2000) 24: 539. doi:10.1007/s002689910087

Abstract.

Angiographic embolization (AE) has been used extensively for bleeding control after injuries to the face and neck. Its role in abdominal trauma requires further exploration. We reviewed the medical records of 137 consecutive patients who underwent angiography with the intent to embolize bleeding sites within the abdomen. Of them, 97 (71%) had blunt and 40 (29%) had penetrating trauma. AE was performed for hemorrhage associated with pelvic fractures (97 patients), liver lacerations (n= 26), renal lacerations (n= 12), splenic lacerations (n= 5), other injuries (n= 9), and multiple injuries (n= 12). On angiography, 102 patients were found to have bleeding sites and underwent AE, with angiographic and clinical bleeding control in 93 (91%). The rate of successful hemostasis by AE was identical in blunt and penetrating trauma patients. There was no major morbidity after AE. No factors predicted patients with a high likelihood to have a positive angiogram. Patients who had AE before or after a period of attempted hemodynamic stabilization in the intensive care unit were no different with respect to hemodynamic parameters immediately before AE or effectiveness of AE for bleeding control. AE is a safe and effective method for controlling bleeding after blunt and penetrating intra- and retroperitoneal injuries. Early AE may be used in selected patients as a front-line therapeutic intervention that offers expeditious hemostasis and prevents delays in definitive bleeding control.

Copyright information

© 2000 by the Société Internationale de Chir 2000

Authors and Affiliations

  • George C. Velmahos
    • 1
  • Santiago Chahwan
    • 1
  • Andres Falabella
    • 1
  • Sue Ellen Hanks
    • 2
  • Demetrios Demetriades
    • 1
  1. 1.Department of Surgery, Division of Trauma and Critical Care, University of Southern California and the Los Angeles County + USC Medical Center, 1200 North State Street, Room 9900, Los Angeles, California 90033, USAUS
  2. 2.Department of Radiology, University of Southern California and the Los Angeles County + USC Medical Center, 1200 North State Street, Room 3550, Los Angeles, California 90033, USAUS