Predictive factors for early failure of transarterial embolization in blunt hepatic injury patients

Lee, Y.-H.; Wu, Cheng‐Hsien; Wang, L.-J.; Wong, Yon-Cheong; Chen, H.-W.; Wang, C.-J.; Lin, Being-Chuan; Hsu, Yung‐Heng

doi:10.1016/j.crad.2014.08.013

Cited by 21 publications

(20 citation statements)

References 22 publications

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“…The median ISS score for the study populations was 24 (range 16.9–36.9). Six studies did not record ISS scores 15, 17, 19–21, 23 . A total of 347 patients with hepatic hemorrhage were embolized from 1992 to 2012, accounting for 34.8% of the total study patients.…”

Section: Resultsmentioning

confidence: 99%

“…The mean age ± SD of embolized patients per study was 31 ± 21.9 (range 12–71). Seven studies recorded the number of patient’s undergoing angiography 15, 16, 19, 20, 23–25 . Over two thirds of patients, 72%, undergoing angiography proceeded to embolization.…”

Section: Resultsmentioning

confidence: 99%

“…A single study accounted for 30 cases (63%) of hepatic necrosis 16 . Details on abscess formation were obtained from 9 studies 15–19, 21, 22, 24, 25 . A total of 23 patients (7.5%) developed hepatic abscesses or infected hepatic collections post embolization.…”

Section: Resultsmentioning

confidence: 99%

“…If a complication was not reported, then a complication was assumed to not occur; this assumption could have impacted our results. Lee et al reported no AE-related complications, but did not describe non-AE specific complications such as abscess formation or bile leak 19 . It seems unlikely that none of these complications occurred in the third largest study population.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes and complications of angioembolization for hepatic trauma

Green

Bulger

Kwan

2016

Journal of Trauma and Acute Care Surgery

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Background The liver is one of the most frequently injured abdominal organs. Hepatic hemorrhage is a complex and challenging complication following hepatic trauma. Significant shifts in the treatment of hepatic hemorrhage, including the increasing use of angioembolization, are believed to have improved patient outcomes. We aimed to describe the efficacy of angioembolization in the setting of acute hepatic arterial hemorrhage, as well as the complications associated with this treatment modality. Methods A systematic review of published literature (MEDLINE, SCOPUS, and Cochrane Library) describing hepatic angioembolization in the setting of trauma was performed. Articles that fulfilled the predetermined inclusion and exclusion criteria were included. We analyzed the efficacy rate of angioembolization in the setting of traumatic hepatic hemorrhage as well as the complications associated with hepatic angioembolization. Results Four hundred and fifty nine articles were identified in the literature search. Of these, 10 retrospective studies and 1 prospective study met inclusion and exclusion criteria. Efficacy rate of angioembolization was 93%. The most frequently reported complications following hepatic angioembolization included hepatic necrosis (15%), abscess formation (7.5%), and bile leaks. Conclusion Although the outcomes of hepatic angioembolization were generally favorable with a high success rate, the treatment modality is not without associated morbidity. The most frequently associated major complication was hepatic necrosis. Rates of complications were affected by study heterogeneity and should be better defined in future studies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Outcomes and complications of angioembolization for hepatic trauma

Green

Bulger

Kwan

2016

Journal of Trauma and Acute Care Surgery

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“…Mechanism of injury was not specified in all studies, [13][14][15][16][17][18][19][20][21][22] even if motor vehicle accident was the most frequent cause [13][14][15][16][17][18][19][20][21][22] ( Figure 1a-c). The AAST grade of liver injury was reported in almost all the studies, 13,15,17,[20][21][22] in particular in a total of 172 patients, as reported below, 18 Grade II, 53 Grade III, 77 Grade IV, 23 Grade V injuries.…”

Section: Liver Injuriesmentioning

confidence: 99%

The role of interventional radiology in abdominopelvic trauma

Ierardi

Duka

Lucchina

et al. 2016

BJR

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The management of trauma patients has evolved in recent decades owing to increasing availability of advanced imaging modalities such as CT. Nowadays, CT has replaced the diagnostic function of angiography. The latter is considered when a therapeutic option is hypothesized. Arterial embolization is a life-saving procedure in abdominopelvic haemorrhagic patients, reducing relevant mortality rates and ensuring haemodynamic stabilization of the patient. Percutaneous transarterial embolization has been shown to be effective for controlling ongoing bleeding for patients with high-grade abdominopelvic injuries, thereby reducing the failure rate of non-operative management, preserving maximal organ function. Surgery is not always the optimal solution for stabilization of a patient with polytrauma. Mini-invasivity and repeatability may be considered as relevant advantages. We review technical considerations, efficacy and complication rates of hepatic, splenic, renal and pelvic embolization to extrapolate current evidence about transarterial embolization in traumatic patients.

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