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CardioVascular and Interventional Radiology

, Volume 35, Issue 1, pp 65–75 | Cite as

Endovascular Treatment of Acute Arterial Hemorrhage in Trauma Patients Using Ethylene Vinyl Alcohol Copolymer (Onyx)

  • R. Müller-WilleEmail author
  • P. Heiss
  • T. Herold
  • E. M. Jung
  • A. G. Schreyer
  • O. W. Hamer
  • J. Rennert
  • P. Hoffstetter
  • C. Stroszczynski
  • N. Zorger
Clinical Investigation

Abstract

Purpose

This study was designed to determine the feasibility and efficacy of endovascular embolization with liquid embolic agent ethylene vinyl alcohol copolymer (Onyx) in patients with acute traumatic arterial bleeding.

Methods

This is a retrospective review of 13 patients (9 men and 4 women; mean age 45 years) with severe trauma who underwent embolotherapy using Onyx from November 2003 to February 2009. Bleeding was located in the pelvis (5 patients), kidney (3 patients), mesenteric region (2 patients), retroperitoneal space (2 patients), neck (1 patient), and thigh (1 patient). In three cases (23.1%), Onyx was used in conjunction with coils. We evaluate the technical and clinical success, procedural and embolization time, occurrence of rebleeding, and embolotherapy-related complications, such as necrosis or migration of Onyx into nontarget vessels.

Results

In all patients, embolotherapy was technically and clinically successful on the first attempt. Control of bleeding could be reached with a mean time of 19 (range, 4–63) min after correct placement of the microcatheter in the feeding artery. No recurrent bleeding was detected. No unintended necrosis or migration of Onyx into a nontarget region was observed. During the follow-up period, three patients (23.1%) died due to severe intracranial hemorrhage, cardiac arrest, and sepsis.

Conclusions

Transcatheter embolization with new liquid embolic agent Onyx is technically feasible and effective in trauma patients with acute arterial hemorrhage.

Keywords

Arterial intervention Embolization embolotherapy Trauma 

Notes

Conflict of interest

We certify that there is no actual or potential conflict of interest in relation to this article.

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Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2011

Authors and Affiliations

  • R. Müller-Wille
    • 1
    Email author
  • P. Heiss
    • 1
  • T. Herold
    • 2
  • E. M. Jung
    • 1
  • A. G. Schreyer
    • 1
  • O. W. Hamer
    • 1
  • J. Rennert
    • 1
  • P. Hoffstetter
    • 1
  • C. Stroszczynski
    • 1
  • N. Zorger
    • 3
  1. 1.Department of RadiologyUniversity Medical Center RegensburgRegensburgGermany
  2. 2.Department of RadiologyHelios Klinikum Berlin-BuchBerlinGermany
  3. 3.Department of RadiologyKrankenhaus Barmherzige Brüder RegensburgRegensburgGermany

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