Endovascular Treatment of Arterial Injury as an Uncommon Complication after Orthopedic Surgery

Endovascular Treatment in Emergency Setting of Acute Arterial Injuries After Orthopedic Surgery

“…Their incidence was in accordance with the occurrence of arterial complications after orthopedic surgery as reported in the literature [3,17,18]. Failure of surgical attempts by experienced personnel to control bleeding, repeated episodes of bleeding, and bleeding sources that were not immediately evidentsuch as inability to maintain satisfactory hemoglobin and haematocrit levels and evolving coagulation defect leading to a further deteriorationare situations in which endovascular treatment is indicated [2].…”

“…In the literature, TAE for iatrogenic orthopedic injury has been reported in some case reports [8,23] and a few series [3,15]. As described previously [5,6,8,12], the coaxial technique with microcatheter and microcoil systems allows precise localization and catheterization of the bleeding arterial branches with minimal tissue compromise [24].…”

“…In patients in a hemodynamically stable condition, it might be adequate to control active extravasation. Moreover, it might be useful when coil embolization requires reinforcement with additional embolic agents [3,25].…”

“…Arterial lesions may occur during surgery, during the immediate postsurgical phase, during the interim phase, or during the long-term phase. They may further manifest as acute limb-threatening ischemia or acute life-threatening hemorrhage [1,3].…”

Transarterial embolization of large complex arteriovenous fistula associated with hip joint surgery

“…Although this injury occurs rarely, with an incidence ranging from 0.005% to 0.5%, early diagnosis and prompt treatment are essential to prevent fatal limb-threatening ischemia or life-threatening hemorrhage often related to arterial injury. 3 Arteriovenous fi stula⎯an abnormal communication between a high-fl ow arterial system and low-fl ow venous network⎯is acquired almost exclusively by penetrating injuries. 4 Pathophysiologically, the artery and adjacent vein may be simultaneously lacerated by an injury, and an abnormal communication may then form and remain during the natural healing process, fi nally forming an AVF.…”