Predicting Suitable Percutaneous Endovascular Arterial Embolization for Traumatic Abdominopelvic Injuries: A Retrospective Cohort Study
Abdulaziz Mohammad Al-Sharydah Diagnostic and Interventional Radiology Department, Imam Abdulrahman Bin Faisal University, College of Medicine, King Fahd Hospital of the University, Al-Khobar City, Eastern Province, Saudi ArabiaCorrespondence: Abdulaziz Mohammad Al-Sharydah, Diagnostic and Intervent...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2022-10-01
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| Series: | Open Access Emergency Medicine |
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| Online Access: | https://www.dovepress.com/predicting-suitable-percutaneous-endovascular-arterial-embolization-fo-peer-reviewed-fulltext-article-OAEM |
| _version_ | 1797998448090284032 |
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| author | Al-Sharydah AM |
| author_facet | Al-Sharydah AM |
| author_sort | Al-Sharydah AM |
| collection | DOAJ |
| description | Abdulaziz Mohammad Al-Sharydah Diagnostic and Interventional Radiology Department, Imam Abdulrahman Bin Faisal University, College of Medicine, King Fahd Hospital of the University, Al-Khobar City, Eastern Province, Saudi ArabiaCorrespondence: Abdulaziz Mohammad Al-Sharydah, Diagnostic and Interventional Radiology Department, Imam Abdulrahman Bin Faisal University, College of Medicine, King Fahd Hospital of the University, PO Box: 31952, Al-Khobar City, Eastern Province, 4398, Saudi Arabia, Fax +966 013 8676697, Email Amsharydah@iau.edu.saPurpose: This study evaluated the pre-procedural attributes of trauma patients to determine their suitability to undergo Percutaneous Endovascular Arterial Embolization (PEAE), and the current state of endovascular repair as an option for trauma-related injuries in traumatic abdominopelvic arterial injuries was explored.Patients and Methods: We retrospectively evaluated the charts of 638 adults with traumatic abdominopelvic injuries treated from March 2011 to February 2021, extensively reviewing their pre-operative indices, pre-operative optimization requirements, and multi-modality imaging records.Results: In total, 235 patients (30.63%) were “hemodynamically unstable” on admission, mainly due to hypotension (n=437 [68.5%]). Additionally, laboratory-defined acquired coagulopathies and inherited bleeding disorders were found in 268 patients (42.01%). The computerized tomography bleeding protocol was performed on 408 (63.94%) patients. Percutaneous endovascular therapy by arterial embolization was performed on 146 patients. The mean number of requested pre-intervention blood units for trauma patients significantly exceeded the number of units transfused post-intervention (P< 0.0005). Apart from hemodynamics (ie heart rate, mean blood pressure); hemoglobin, and lactic acid levels were independently associated indices of PEAE outcomes (p < 0.01).Conclusion: Despite the recommendations from the Society of Interventional Radiology on endovascular intervention for trauma and bleeding risk, 36.84% of study patients had hemodynamic instability and other unfeasible parameters that would limit the option of minimally invasive procedures. Early recognition and consideration of suitable treatment options is essential for optimizing patient outcomes. It is imperative that standardized algorithms and management protocols based on available resources be developed.Keywords: interventional radiology, injury, embolization, surgery, emergency medicine |
| first_indexed | 2024-04-11T10:48:56Z |
| format | Article |
| id | doaj.art-7c4454352c6d4a7c93282abdf8fbb8a9 |
| institution | Directory Open Access Journal |
| issn | 1179-1500 |
| language | English |
| last_indexed | 2024-04-11T10:48:56Z |
| publishDate | 2022-10-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Open Access Emergency Medicine |
| spelling | doaj.art-7c4454352c6d4a7c93282abdf8fbb8a92022-12-22T04:28:58ZengDove Medical PressOpen Access Emergency Medicine1179-15002022-10-01Volume 1454555678694Predicting Suitable Percutaneous Endovascular Arterial Embolization for Traumatic Abdominopelvic Injuries: A Retrospective Cohort StudyAl-Sharydah AMAbdulaziz Mohammad Al-Sharydah Diagnostic and Interventional Radiology Department, Imam Abdulrahman Bin Faisal University, College of Medicine, King Fahd Hospital of the University, Al-Khobar City, Eastern Province, Saudi ArabiaCorrespondence: Abdulaziz Mohammad Al-Sharydah, Diagnostic and Interventional Radiology Department, Imam Abdulrahman Bin Faisal University, College of Medicine, King Fahd Hospital of the University, PO Box: 31952, Al-Khobar City, Eastern Province, 4398, Saudi Arabia, Fax +966 013 8676697, Email Amsharydah@iau.edu.saPurpose: This study evaluated the pre-procedural attributes of trauma patients to determine their suitability to undergo Percutaneous Endovascular Arterial Embolization (PEAE), and the current state of endovascular repair as an option for trauma-related injuries in traumatic abdominopelvic arterial injuries was explored.Patients and Methods: We retrospectively evaluated the charts of 638 adults with traumatic abdominopelvic injuries treated from March 2011 to February 2021, extensively reviewing their pre-operative indices, pre-operative optimization requirements, and multi-modality imaging records.Results: In total, 235 patients (30.63%) were “hemodynamically unstable” on admission, mainly due to hypotension (n=437 [68.5%]). Additionally, laboratory-defined acquired coagulopathies and inherited bleeding disorders were found in 268 patients (42.01%). The computerized tomography bleeding protocol was performed on 408 (63.94%) patients. Percutaneous endovascular therapy by arterial embolization was performed on 146 patients. The mean number of requested pre-intervention blood units for trauma patients significantly exceeded the number of units transfused post-intervention (P< 0.0005). Apart from hemodynamics (ie heart rate, mean blood pressure); hemoglobin, and lactic acid levels were independently associated indices of PEAE outcomes (p < 0.01).Conclusion: Despite the recommendations from the Society of Interventional Radiology on endovascular intervention for trauma and bleeding risk, 36.84% of study patients had hemodynamic instability and other unfeasible parameters that would limit the option of minimally invasive procedures. Early recognition and consideration of suitable treatment options is essential for optimizing patient outcomes. It is imperative that standardized algorithms and management protocols based on available resources be developed.Keywords: interventional radiology, injury, embolization, surgery, emergency medicinehttps://www.dovepress.com/predicting-suitable-percutaneous-endovascular-arterial-embolization-fo-peer-reviewed-fulltext-article-OAEMinterventional radiologyinjuryembolizationsurgeryemergency medicine |
| spellingShingle | Al-Sharydah AM Predicting Suitable Percutaneous Endovascular Arterial Embolization for Traumatic Abdominopelvic Injuries: A Retrospective Cohort Study Open Access Emergency Medicine interventional radiology injury embolization surgery emergency medicine |
| title | Predicting Suitable Percutaneous Endovascular Arterial Embolization for Traumatic Abdominopelvic Injuries: A Retrospective Cohort Study |
| title_full | Predicting Suitable Percutaneous Endovascular Arterial Embolization for Traumatic Abdominopelvic Injuries: A Retrospective Cohort Study |
| title_fullStr | Predicting Suitable Percutaneous Endovascular Arterial Embolization for Traumatic Abdominopelvic Injuries: A Retrospective Cohort Study |
| title_full_unstemmed | Predicting Suitable Percutaneous Endovascular Arterial Embolization for Traumatic Abdominopelvic Injuries: A Retrospective Cohort Study |
| title_short | Predicting Suitable Percutaneous Endovascular Arterial Embolization for Traumatic Abdominopelvic Injuries: A Retrospective Cohort Study |
| title_sort | predicting suitable percutaneous endovascular arterial embolization for traumatic abdominopelvic injuries a retrospective cohort study |
| topic | interventional radiology injury embolization surgery emergency medicine |
| url | https://www.dovepress.com/predicting-suitable-percutaneous-endovascular-arterial-embolization-fo-peer-reviewed-fulltext-article-OAEM |
| work_keys_str_mv | AT alsharydaham predictingsuitablepercutaneousendovasculararterialembolizationfortraumaticabdominopelvicinjuriesaretrospectivecohortstudy |