Therapeutic Embolization for the Treatment of Recurrent Hemarthrosis After Total Knee Arthroplasty due to an Arteriovenous Fistula

Kalsi, Pratipal; Carrington, R.; Skinner, John

doi:10.1016/j.arth.2006.11.012

Cited by 21 publications

(15 citation statements)

References 15 publications

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“…Sizes of particles chosen were 150-250 or 250-350 μm for PA and 500-700 μm for TAGM. Genicular arterial branches and/or the supra-articular popliteal artery were target arteries selectively embolized (4,(7)(8)(9)(10)(11)(12)(13)(14). In all cases reported, embolization was technically successful, with no clinical recurrence except for one.…”

Section: Discussionmentioning

confidence: 96%

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Selective arterial embolization with gelatin particles for refractory knee hemarthrosis

Yamagami

Yoshimatsu²,

Miura³

et al. 2013

Diagn Interv Radiol

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Section: Discussionmentioning

confidence: 96%

“…In addition to surgical methods, case reports in which knee hemarthrosis was successfully treated by transarterial embolization, which is less invasive, have been published as listed in Table 2 (4,(7)(8)(9)(10)(11)(12)(13)(14). All but one of these reports describe treatment for recurrent hemarthrosis after total knee arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

Selective arterial embolization with gelatin particles for refractory knee hemarthrosis

Yamagami

Yoshimatsu²,

Miura³

et al. 2013

Diagn Interv Radiol

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“…Vascular injuries related to the LSGA are quite rare, with only two reported cases of isolated pseudoaneurysm formation1 2 and two cases of AVF 3 4…”

Section: Discussionmentioning

confidence: 99%

Multi-detector CT angiography in case of concomitant pseudoaneurysm and arteriovenous fistula of the lateral superior geniculate artery

Saboo

Juan

Belkin

et al. 2013

Postgraduate Medical Journal

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“…Therefore, the purpose of this systematic review and meta-analysis was to further characterize the efficacy and safety of embolization for hemarthroses following TKA. Specifically, we sought to determine the: (1) rate of symptom relief after treatment with selective embolization, (2) average rate of embolization procedures performed, as well as the proportion of patients requiring multiple procedures, and (3) rate of major and minor complications.…”

mentioning

confidence: 99%

Selective Embolization Is Safe and Effective for Total Knee Arthroplasty-Associated Recurrent Hemarthroses: A Systematic Review and Meta-Analysis

et al. 2019

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Total knee arthroplasty (TKA)-associated hemarthroses are infrequent and often respond to nonoperative therapy. Geniculate artery embolization may provide symptomatic relief in cases recalcitrant to needle aspiration, although no meta-analysis exists regarding this therapy. This meta-analysis aims to assess the rate of symptom relief, the number of embolizations needed to achieve relief, and the rate of complications associated with embolization. Public databases were queried from 1998 until 2018 for TKA-associated recurrent hemarthroses treated with embolization. Eight studies met inclusion and exclusion criteria. Major complications were defined as those requiring readmission or nonelective reoperation; minor complications were defined as those not requiring readmission or reoperation. Pooled statistics were calculated utilizing the method of inverse variance. Fifty-nine patients with a mean follow-up of 30 months (range, 1–50 months) were evaluated. The pooled proportion of patients with symptom improvement following embolization was 86% (95% confidence interval [CI]: 74–93%, I 2: 0%, p = 0.97). The average number of embolization procedures was 1.30 (95% CI: 1.03–1.63, I 2: 0%, p = 0.66). The pooled proportion of patients who required a second embolization procedure was 26% (95% CI: 15–40%, I 2: 0%, p = 0.43), while those requiring three or more procedures was 13% (95% CI: 6–25%, I 2: 0%, p = 0.87). The rate of complications were as follows: any complication – 19% (95% CI: 11–32%, I 2: 0%, p = 0.81); major complications–8% (95% CI: 3–19%, I 2: 0%, p = 0.96); minor complications–18% (95% CI: 10–31%, I 2: 0%, p = 0.79); inguinal hematoma–9% (95% CI: 4–19%, I 2: 0%, p = 1.00); skin necrosis–15% (95% CI: 7–29%, I 2: 0%, p = 0.62); and incision breakdown–7% (95% CI: 3–17%, I 2: 0%, p = 1.00). Previous literature on selective artery embolization following TKA is relatively limited. This meta-analysis supports embolization as a potentially safe and effective treatment for recurrent hemarthroses after TKA. Other correctable causes of recurrent hemarthrosis, such as instability or malalignment, must be diligently ruled out prior to utilizing embolization. Surgeons should be aware of embolization's potential role in the postoperative period following TKA.

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Therapeutic Embolization for the Treatment of Recurrent Hemarthrosis After Total Knee Arthroplasty due to an Arteriovenous Fistula

Cited by 21 publications

References 15 publications

Selective arterial embolization with gelatin particles for refractory knee hemarthrosis

Selective arterial embolization with gelatin particles for refractory knee hemarthrosis

Multi-detector CT angiography in case of concomitant pseudoaneurysm and arteriovenous fistula of the lateral superior geniculate artery

Selective Embolization Is Safe and Effective for Total Knee Arthroplasty-Associated Recurrent Hemarthroses: A Systematic Review and Meta-Analysis

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