Transcatheter Arterial Embolization for Bleeding Related to Pelvic Trauma: Comparison of Technical and Clinical Results between Hemodynamically Stable and Unstable Patients
Background: Endovascular intervention is now the primary line of therapy for arterial injury brought on by pelvic trauma since it can significantly reduce considerable morbidity associated with surgery and can swiftly access and control bleeding sites. Despite international guidelines and widespread...
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-09-01
|
| Series: | Tomography |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2379-139X/9/5/133 |
| _version_ | 1797572178543116288 |
|---|---|
| author | Roberto Minici Michele Mercurio Giuseppe Guzzardi Massimo Venturini Federico Fontana Luca Brunese Pasquale Guerriero Raffaele Serra Filippo Piacentino Marco Spinetta Lorenzo Zappia Davide Costa Andrea Coppola MGJR Research Team Olimpio Galasso Domenico Laganà |
| author_facet | Roberto Minici Michele Mercurio Giuseppe Guzzardi Massimo Venturini Federico Fontana Luca Brunese Pasquale Guerriero Raffaele Serra Filippo Piacentino Marco Spinetta Lorenzo Zappia Davide Costa Andrea Coppola MGJR Research Team Olimpio Galasso Domenico Laganà |
| author_sort | Roberto Minici |
| collection | DOAJ |
| description | Background: Endovascular intervention is now the primary line of therapy for arterial injury brought on by pelvic trauma since it can significantly reduce considerable morbidity associated with surgery and can swiftly access and control bleeding sites. Despite international guidelines and widespread awareness of the role of angioembolization in clinical practice, robust evidence comparing the outcomes of angioembolization in hemodynamically stable and unstable patients is still lacking. This study aims to directly compare the outcomes of angioembolization for the treatment of pelvic traumatic arterial injury in patients with hemodynamic stability vs. hemodynamic instability. Methods: In our multicenter retrospective investigation, we analyzed data from consecutive patients who underwent, from January 2020 to May 2023, angioembolization for traumatic pelvic arterial injury. Results: In total, 116 angioembolizations were performed. Gelatin sponges (56.9%) and coils (25.9%) were the most widely used embolic agents. The technical and clinical success rates were 100% and 91.4%, respectively. No statistically significant differences were observed between the two groups in terms of technical success, clinical success, procedure-related complication rate, or 30-day bleeding-related mortality. Conclusions: Angioembolization is an effective and safe option for the management of traumatic pelvic arterial lesions even in hemodynamically unstable patients, despite technical variations such as greater use of prophylactic angioembolization. |
| first_indexed | 2024-03-10T20:50:54Z |
| format | Article |
| id | doaj.art-44b874b2b76a4872a5046b766d145ca2 |
| institution | Directory Open Access Journal |
| issn | 2379-1381 2379-139X |
| language | English |
| last_indexed | 2024-03-10T20:50:54Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Tomography |
| spelling | doaj.art-44b874b2b76a4872a5046b766d145ca22023-11-19T18:20:47ZengMDPI AGTomography2379-13812379-139X2023-09-01951660168210.3390/tomography9050133Transcatheter Arterial Embolization for Bleeding Related to Pelvic Trauma: Comparison of Technical and Clinical Results between Hemodynamically Stable and Unstable PatientsRoberto Minici0Michele Mercurio1Giuseppe Guzzardi2Massimo Venturini3Federico Fontana4Luca Brunese5Pasquale Guerriero6Raffaele Serra7Filippo Piacentino8Marco Spinetta9Lorenzo Zappia10Davide Costa11Andrea Coppola12MGJR Research Team13Olimpio Galasso14Domenico Laganà15Radiology Unit, Dulbecco University Hospital, 88100 Catanzaro, ItalyDepartment of Orthopaedic and Trauma Surgery, Magna Græcia University, Dulbecco University Hospital, 88100 Catanzaro, ItalyRadiology Unit, Maggiore della Carità University Hospital, 28100 Novara, ItalyDiagnostic and Interventional Radiology Unit, ASST Settelaghi, Insubria University, 21100 Varese, ItalyDiagnostic and Interventional Radiology Unit, ASST Settelaghi, Insubria University, 21100 Varese, ItalyDepartment of Medicine and Health Sciences, University of Molise, 86100 Campobasso, ItalyDepartment of Medicine and Health Sciences, University of Molise, 86100 Campobasso, ItalyVascular Surgery Unit, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Dulbecco University Hospital, 88100 Catanzaro, ItalyDiagnostic and Interventional Radiology Unit, ASST Settelaghi, Insubria University, 21100 Varese, ItalyRadiology Unit, Maggiore della Carità University Hospital, 28100 Novara, ItalyRadiology Unit, Dulbecco University Hospital, 88100 Catanzaro, ItalyDepartment of Law, Economics and Sociology, Magna Graecia University of Catanzaro, 88100 Catanzaro, ItalyDiagnostic and Interventional Radiology Unit, ASST Settelaghi, Insubria University, 21100 Varese, ItalyMagna Graecia Junior Radiologists Research Team, 88100 Catanzaro, ItalyDepartment of Orthopaedic and Trauma Surgery, Magna Græcia University, Dulbecco University Hospital, 88100 Catanzaro, ItalyRadiology Unit, Dulbecco University Hospital, 88100 Catanzaro, ItalyBackground: Endovascular intervention is now the primary line of therapy for arterial injury brought on by pelvic trauma since it can significantly reduce considerable morbidity associated with surgery and can swiftly access and control bleeding sites. Despite international guidelines and widespread awareness of the role of angioembolization in clinical practice, robust evidence comparing the outcomes of angioembolization in hemodynamically stable and unstable patients is still lacking. This study aims to directly compare the outcomes of angioembolization for the treatment of pelvic traumatic arterial injury in patients with hemodynamic stability vs. hemodynamic instability. Methods: In our multicenter retrospective investigation, we analyzed data from consecutive patients who underwent, from January 2020 to May 2023, angioembolization for traumatic pelvic arterial injury. Results: In total, 116 angioembolizations were performed. Gelatin sponges (56.9%) and coils (25.9%) were the most widely used embolic agents. The technical and clinical success rates were 100% and 91.4%, respectively. No statistically significant differences were observed between the two groups in terms of technical success, clinical success, procedure-related complication rate, or 30-day bleeding-related mortality. Conclusions: Angioembolization is an effective and safe option for the management of traumatic pelvic arterial lesions even in hemodynamically unstable patients, despite technical variations such as greater use of prophylactic angioembolization.https://www.mdpi.com/2379-139X/9/5/133angioembolizationtraumapelvic injuryhemodynamic instabilitytranscatheter arterial embolizationbleeding |
| spellingShingle | Roberto Minici Michele Mercurio Giuseppe Guzzardi Massimo Venturini Federico Fontana Luca Brunese Pasquale Guerriero Raffaele Serra Filippo Piacentino Marco Spinetta Lorenzo Zappia Davide Costa Andrea Coppola MGJR Research Team Olimpio Galasso Domenico Laganà Transcatheter Arterial Embolization for Bleeding Related to Pelvic Trauma: Comparison of Technical and Clinical Results between Hemodynamically Stable and Unstable Patients Tomography angioembolization trauma pelvic injury hemodynamic instability transcatheter arterial embolization bleeding |
| title | Transcatheter Arterial Embolization for Bleeding Related to Pelvic Trauma: Comparison of Technical and Clinical Results between Hemodynamically Stable and Unstable Patients |
| title_full | Transcatheter Arterial Embolization for Bleeding Related to Pelvic Trauma: Comparison of Technical and Clinical Results between Hemodynamically Stable and Unstable Patients |
| title_fullStr | Transcatheter Arterial Embolization for Bleeding Related to Pelvic Trauma: Comparison of Technical and Clinical Results between Hemodynamically Stable and Unstable Patients |
| title_full_unstemmed | Transcatheter Arterial Embolization for Bleeding Related to Pelvic Trauma: Comparison of Technical and Clinical Results between Hemodynamically Stable and Unstable Patients |
| title_short | Transcatheter Arterial Embolization for Bleeding Related to Pelvic Trauma: Comparison of Technical and Clinical Results between Hemodynamically Stable and Unstable Patients |
| title_sort | transcatheter arterial embolization for bleeding related to pelvic trauma comparison of technical and clinical results between hemodynamically stable and unstable patients |
| topic | angioembolization trauma pelvic injury hemodynamic instability transcatheter arterial embolization bleeding |
| url | https://www.mdpi.com/2379-139X/9/5/133 |
| work_keys_str_mv | AT robertominici transcatheterarterialembolizationforbleedingrelatedtopelvictraumacomparisonoftechnicalandclinicalresultsbetweenhemodynamicallystableandunstablepatients AT michelemercurio transcatheterarterialembolizationforbleedingrelatedtopelvictraumacomparisonoftechnicalandclinicalresultsbetweenhemodynamicallystableandunstablepatients AT giuseppeguzzardi transcatheterarterialembolizationforbleedingrelatedtopelvictraumacomparisonoftechnicalandclinicalresultsbetweenhemodynamicallystableandunstablepatients AT massimoventurini transcatheterarterialembolizationforbleedingrelatedtopelvictraumacomparisonoftechnicalandclinicalresultsbetweenhemodynamicallystableandunstablepatients AT federicofontana transcatheterarterialembolizationforbleedingrelatedtopelvictraumacomparisonoftechnicalandclinicalresultsbetweenhemodynamicallystableandunstablepatients AT lucabrunese transcatheterarterialembolizationforbleedingrelatedtopelvictraumacomparisonoftechnicalandclinicalresultsbetweenhemodynamicallystableandunstablepatients AT pasqualeguerriero transcatheterarterialembolizationforbleedingrelatedtopelvictraumacomparisonoftechnicalandclinicalresultsbetweenhemodynamicallystableandunstablepatients AT raffaeleserra transcatheterarterialembolizationforbleedingrelatedtopelvictraumacomparisonoftechnicalandclinicalresultsbetweenhemodynamicallystableandunstablepatients AT filippopiacentino transcatheterarterialembolizationforbleedingrelatedtopelvictraumacomparisonoftechnicalandclinicalresultsbetweenhemodynamicallystableandunstablepatients AT marcospinetta transcatheterarterialembolizationforbleedingrelatedtopelvictraumacomparisonoftechnicalandclinicalresultsbetweenhemodynamicallystableandunstablepatients AT lorenzozappia transcatheterarterialembolizationforbleedingrelatedtopelvictraumacomparisonoftechnicalandclinicalresultsbetweenhemodynamicallystableandunstablepatients AT davidecosta transcatheterarterialembolizationforbleedingrelatedtopelvictraumacomparisonoftechnicalandclinicalresultsbetweenhemodynamicallystableandunstablepatients AT andreacoppola transcatheterarterialembolizationforbleedingrelatedtopelvictraumacomparisonoftechnicalandclinicalresultsbetweenhemodynamicallystableandunstablepatients AT mgjrresearchteam transcatheterarterialembolizationforbleedingrelatedtopelvictraumacomparisonoftechnicalandclinicalresultsbetweenhemodynamicallystableandunstablepatients AT olimpiogalasso transcatheterarterialembolizationforbleedingrelatedtopelvictraumacomparisonoftechnicalandclinicalresultsbetweenhemodynamicallystableandunstablepatients AT domenicolagana transcatheterarterialembolizationforbleedingrelatedtopelvictraumacomparisonoftechnicalandclinicalresultsbetweenhemodynamicallystableandunstablepatients |