Clinical characteristics of pelvic fracture patients with gluteal necrosis resulting from transcatheter arterial embolization

Suzuki, Takashi; Shindo, Mitsuko; Kataoka, Yuichi; Kobayashi, Ikuko; Nishimaki, Hiroshi; Yamamoto, Shinichiro; Uchino, Motoi; Takahira, Naonobu; Yokoyama, Kazuhiko; Soma, Kazui

doi:10.1007/s00402-005-0827-1

Cited by 69 publications

(45 citation statements)

References 12 publications

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“…With regard to TAE, if a major artery is embolized and then the artery that supplies the only collaterals to the same area is occluded as well, ischemic damage could occur in theory. Complications with this procedure have been reported such as bladder wall necrosis [7,8], paresis [9], impotence [10], and in addition, gluteal soft tissue necrosis, such as skin necrosis [11,12] and gluteal muscle necrosis [3,[13][14][15]. In both of our cases, the patients underwent TAE.…”

Section: Discussionmentioning

confidence: 99%

Gluteal Soft Tissue Necrosis After Transcatheter Angiographic Embolization for Pelvic Fracture: a Report of Two Cases

Katô

Otomo

Homma

et al. 2007

Eur J Trauma Emerg Surg

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In this paper, two cases of the gluteal soft tissue necrosis after pelvic fractures will be discussed. In the case of a 29-year-old man, a localized area of skin necrosis on the buttock appeared after transcatheter arterial embolization (TAE) of the right internal iliac artery (IIA). In the second case, a 52-year-old man, who was treated using TAE of the bilateral IIA's, developed an extensive area of necrosis in the gluteus maximus muscle with subsequent severe infection. In both cases, complete excision of the necrotic tissue and reconstructive flap surgery were imperative. Gluteal soft tissue necrosis is clinically important as one of the serious complications of TAE.

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Section: Discussionmentioning

confidence: 99%

Gluteal Soft Tissue Necrosis After Transcatheter Angiographic Embolization for Pelvic Fracture: a Report of Two Cases

Katô

Otomo

Homma

et al. 2007

Eur J Trauma Emerg Surg

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“…Complications previously associated with PAE, including gluteus muscle necrosis [13,14,19], bladder necrosis [12], skin necrosis [6], impotence [7], and surgical wound complications [15], were noted.…”

Section: Methodsmentioning

confidence: 98%

“…Although PAE is considered by many to be a safe procedure with minimal short-term complications [10,16,17], the loss of blood supply to the end organ can result in significant consequences. Complications such as gluteal [13,14,19], bladder [12], femoral head [9], and skin necrosis [6] all have been reported in association with PAE. Moreover, paresis [4], impotence [7], and surgical wound complications [15] have also been described after embolization in the pelvic region.…”

Section: Introductionmentioning

confidence: 99%

Acute Complications of Patients With Pelvic Fractures After Pelvic Angiographic Embolization

Matityahu¹,

Marmor²,

Elson³

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Hemodynamically unstable patients with a pelvic fracture and arterial pelvic bleeding frequently are treated with pelvic angiographic embolization (PAE). PAE is reported to be a safe and effective method of controlling hemorrhage. However, the loss of blood supply and subsequent ischemia from embolization may lead to adverse consequences. Objectives/purposes We sought to determine (1) the frequency and types of complications observed after PAE;(2) the mortality after PAE; and (3) the clinical factors associated with complications and mortality after PAE. Methods We conducted a retrospective case series descriptive study at a Level I trauma center. Using our institution's trauma registry, we isolated patients with pelvic fractures treated with PAE admitted between June 1999 and December 2007. Complications attributed to PAE occurring in the initial hospital stay were recorded. We identified 98 patients with pelvic fractures treated by PAE with an average hospital stay of 25.3 days. Results The complication rate was 11% and included six patients with gluteal muscle necrosis (6%), five with surgical wound breakdown (5%), four deep infections (4%), one superficial infection, two patients with of impotence (2%), and one with bladder necrosis. The mortality rate in the PAE group reached 20%. Bilateral embolization was performed in 100% of the patients with complications.

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“…Although TAE is one of the most useful modalities for con- ma, it may be associated with various complications, including puncture site hematoma, impotence, iliofemoral embolization, paraparesis, and ischemic necrosis of the bladder wall, gluteal skin, femoral head, gluteal muscle, and colon (6)(7)(8)(9)(10)(11)(12)(13). Super-selective catheterization of injured vessels may be a good option for avoiding complications related to TAE, because the blood flow to adjacent structures can be maintained by selectively embolizing only the injured vessel.…”

Section: Introductionmentioning

confidence: 99%

“…Gluteal muscle necrosis after proximal embolization at the internal iliac artery level is most frequently reported, and its estimated incidence is about 6% (7,8,(10)(11)(12)(13). Surgical wound break down (12), pelvic organ infarction, including colon, ileum, ureter, and rectum (7,9), and neurologic complications, such as lower limb paresis, sacral plexus palsy, and sciatic palsy (9), have also been reported.…”

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confidence: 99%

Embolization of Trauma-Associated Pelvic Hemorrhage: Feasibility of Super-Selective Catheterization in Heavily Injured Patients as a Damage Control for Life-Threatening Pelvic Bleeding

Park

Yim

Kim

et al. 2016

J Korean Soc Radiol

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Purpose:To determine the efficacy of embolization with super-selective catheterization of the internal iliac arterial branches to treat heavily injured trauma patients with pelvic arterial bleeding. Materials and Methods: A retrospective analysis was performed using the medical records of 37 patients who underwent trans-arterial embolization for trauma-associated pelvic arterial hemorrhage in a regional trauma center between July 2010 and July 2013. In each patient, hemodynamic stability, embolization level, elapsed time for trans-arterial embolization, clinical outcome and embolization-related complications were evaluated. Comparison of elapsed time, and presence of complication was done according to embolization level. Results: Transarterial embolization was conducted in 37 patients. Hemodynamic stability of each patient was classified into hemodynamic stable (n = 9), and unstable (n = 28). Twenty-nine of 37 patients underwent embolization after super-selective catheterization of more than 2nd order branch of internal iliac artery with a microcatheter, and 8 patients underwent proximal internal iliac artery embolization without super-selective catheterization. The mean elapsed procedure time for super-selective embolization (34.76 ± 20.0 minutes) was not significantly longer than proximal internal iliac artery embolization (33.87 ± 16.73 minutes, p = 0.215). Conclusion: Pelvic arterial embolization with super-selective catheterization is a safe and feasible treatment for heavily injured patients with trauma-associated pelvic arterial bleeding.

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Clinical characteristics of pelvic fracture patients with gluteal necrosis resulting from transcatheter arterial embolization

Cited by 69 publications

References 12 publications

Gluteal Soft Tissue Necrosis After Transcatheter Angiographic Embolization for Pelvic Fracture: a Report of Two Cases

Gluteal Soft Tissue Necrosis After Transcatheter Angiographic Embolization for Pelvic Fracture: a Report of Two Cases

Acute Complications of Patients With Pelvic Fractures After Pelvic Angiographic Embolization

Embolization of Trauma-Associated Pelvic Hemorrhage: Feasibility of Super-Selective Catheterization in Heavily Injured Patients as a Damage Control for Life-Threatening Pelvic Bleeding

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