scholarly journals Efficacy of median sacral artery embolization for treating severe pelvic fractures: a retrospective study

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110633
Author(s):  
Takaaki Maruhashi ◽  
Yutaro Kurihara ◽  
Marina Oi ◽  
Fumie Kashimi ◽  
Satoshi Tamura ◽  
...  
Keyword(s):  
Medical Records ◽  
Arterial Embolization ◽  
Pelvic Fractures ◽  
Shock Index ◽  
Artery Embolization ◽  
Iliac Arteries ◽  
Unstable Pelvic Fracture ◽  
Median Sacral Artery ◽  
Internal Iliac ◽  
Index Value

Objective Transcatheter arterial embolization (TAE) of bilateral internal iliac arteries (IIAs) in patients with a hemodynamically unstable pelvic fracture is associated with a low mortality rate. The persistence of unstable hemodynamics after IIA embolization indicates the involvement of other arteries, such as the median sacral artery (MSA). This study aimed to evaluate the efficacy of MSA embolization. Methods In this single-center, retrospective, observational study, medical records of patients who underwent MSA angiography or embolization for pelvic fractures (n = 21) between January 2007 and August 2019 were reviewed. The percentage of patients achieving hemodynamic stabilization by MSA embolization was calculated. Results Fifteen patients underwent MSA embolization, and the remaining six underwent MSA angiography. The shock index value was significantly higher after MSA embolization than that before MSA embolization in hemodynamically unstable patients who underwent this procedure. The success rate of MSA selection was 100%. One patient presented with urinary retention because of bladder and rectal disorders after MSA embolization. The 30-day survival rate was 85.7%. Conclusions Severe pelvic fractures, such as a Dennis Zone III fracture and suicidal jumper’s fracture due to trauma from a fall, may require MSA embolization.

scholarly journals Endovascular therapeutic options for the treatment of aortoiliac aneurysms

2016 ◽  
Vol 43 (6) ◽  
pp. 480-485 ◽  
Author(s):  
BERNARDO MASSIÈRE ◽  
ARNO VON-RISTOW ◽  
ALBERTO VESCOVI ◽  
DANIEL LEAL ◽  
LEA MIRIAN BARBOSA FONSECA
Keyword(s):  
Endovascular Treatment ◽  
Internal Iliac Artery ◽  
Aortic Aneurysms ◽  
Colonic Ischemia ◽  
Artery Embolization ◽  
Iliac Arteries ◽  
Abdominal Aortic ◽  
Internal Iliac ◽  
Ischemic Complications ◽  
Internal Iliac Artery Embolization

ABSTRACT About 20% of patients with abdominal aortic aneurysms have associated iliac aneurysms. Distal sealing during the endovascular treatment of aortic-iliac aneurysms is a challenge that has led to the emergence of several technical options to achieve this goal over the years. Internal iliac artery embolization is associated with the risk of ischemic complications, such as gluteal necrosis, lower limb neurological deficit, colonic ischemia, impotence and gluteal claudication. This article summarizes the technical options for endovascular treatment of aortoiliac aneurysms with different approaches to preserving the patency of internal iliac arteries.

scholarly journals Anatomy of the abdominal aorta in the hoary fox (Lycalopex vetulus, Lund, 1842)

2018 ◽  
Vol 55 (4) ◽  
pp. e146491
Author(s):  
Dara Rúbia Souza Silva ◽  
Mônica Duarte da Silva ◽  
Marcos Paulo Batista de Assunção ◽  
Eduardo Paul Chacur ◽  
Daniela Cristina De Oliveira Silva ◽  
...  
Keyword(s):  
Abdominal Aorta ◽  
Median Plane ◽  
Celiac Artery ◽  
Renal Arteries ◽  
Mesenteric Arteries ◽  
Lumbar Region ◽  
Iliac Arteries ◽  
Median Sacral Artery ◽  
Internal Iliac ◽  
Vertebral Bodies

The hoary fox (Lycalopex vetulus, Lund, 1842) is the smallest Brazilian canid, whose weight varies between 2 and 4 kg, has a slender body, a small head, and a short and blackened snout. Despite being considered an endemic species, little is known about the hoary fox as it is one of the seven less studied canids in the world. Thus, this study aimed to describe the anatomy of the abdominal aorta artery of the hoary fox and to compare it with the pre-established literature data in domestic canids. For this purpose, we used two adult hoary foxes without definite age. We collected the corpses of these animals along roadsides of Catalão-GO, being later fixed and conserved in a 10% formalin solution. The results showed that the abdominal aorta in hoary fox is at the ventral face of the lumbar region vertebral bodies, being slightly displaced to the left of the median plane. The first branch is visceral, named celiac artery, followed by a paired parietal branch: the phrenic abdominal arteries. The third and fourth branches are the cranial mesenteric arteries and the rightand left are the renal arteries, respectively. The posterior branches of the renal arteries are equally visceral, paired, being called testicular arteries. Distal to the latter, both the caudal mesenteric artery and deep circumflex iliac arteries originate. Finally, two large external iliac arteries and its terminal branches composed of internal iliac arteries and the median sacral artery originate. In addition, five pairs of lumbar arteries originate alongside the abdominal segment of the aorta. Considering these findings, it is possible to conclude that despite the hoary fox being a wild animal, the anatomy of its abdominal aorta is very similar to that of domestic canids.

scholarly journals Internal Iliac Artery Embolization for the Control of Severe Bladder Hemorrhage Secondary to Carcinoma: Long-Term Follow-Up

2007 ◽  
Vol 7 ◽  
pp. 1567-1574 ◽  
Author(s):  
Ahmed El-Assmy ◽  
Tarek Mohsen
Keyword(s):  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Arterial Embolization ◽  
Artery Embolization ◽  
Severe Hemorrhage ◽  
Long Term Follow Up ◽  
Internal Iliac ◽  
Internal Iliac Artery Embolization

The purpose of this study was to evaluate the efficacy and long-term complications of internal iliac artery embolization as a palliative measure in the control of intractable hemorrhage from advanced bladder malignancy. From January 1998 through December 2005, seven patients underwent transcatheter arterial embolization (TAE) of anterior division of internal iliac artery bilaterally for intractable bladder hemorrhage. After embolization, patients were followed for the efficacy of the procedure in controlling hematuria and complications. TAE was successful in immediate control of severe hemorrhage in all seven patients after a mean period of 4 days. At a mean (range) follow-up of 10 (6–12) months, the hemorrhage was permanently controlled in four (57%) patients. Three patients developed hematuria and required emergency admissions; two had mild hematuria and were managed conservatively, and the remaining one required a second attempt of embolization after 2 months from the first one. During the whole period of follow-up, there were no significant complications related to embolization. Internal iliac artery embolization is an effective and minimally invasive option when managing advanced bladder malignancies presenting with intractable bleeding. The long-term follow-up showed control of bleeding in the majority of such patients with no serious complications.

scholarly journals Novel transcatheter arterial embolization method for hemodynamically unstable pelvic fractures to prevent complications of gluteal necrosis

2019 ◽  
Vol 46 (5) ◽  
pp. 1129-1136 ◽  
Author(s):  
Takaaki Maruhashi ◽  
Fumie Kashimi ◽  
Rika Kotoh ◽  
Shun Kasahara ◽  
Hiroaki Minehara ◽  
...  
Keyword(s):  
Overall Survival ◽  
Transcatheter Arterial Embolization ◽  
Arterial Embolization ◽  
Pelvic Fractures ◽  
Embolic Agent ◽  
Gelatin Sponge ◽  
Procedure Time ◽  
Iliac Arteries ◽  
Significant Difference ◽  
Embolization Procedure

Abstract Purpose To validate our previously designed transcatheter arterial embolization (TAE) technique for bilateral iliac arteries in unstable pelvic fractures, which is designed to also prevent gluteal necrosis and avoid vasopressors. Methods We retrospectively analyzed the data of patients with pelvic fractures who underwent our new TAE procedure to determine the incidence of subsequent gluteal necrosis. We also compared certain variables between patients who underwent TAE before 2005 using a different technique and developed gluteal necrosis and patients who underwent TAE in 2005 and onward using our technique. Gluteal necrosis was confirmed by a radiologist based on imaging findings. Results Seventy patients with pelvic fractures who underwent our TAE technique met the inclusion criteria (bilateral iliac arterial embolization and no embolic agent other than a gelatin sponge). Patients’ median age was 47.5 years, 33 were male, and 92.9% (65/70) had unstable fractures. Sixty-eight patients had severe multiple trauma. No patients developed gluteal necrosis following our TAE procedure and the overall survival rate was 82.9% (58/70). We found no statistically significant difference in procedure time between the previous and new technique, although the new procedure tended to be shorter. Furthermore, overall survival did not significantly differ between the groups. Multiple regression analysis revealed that TAE procedure time and external pelvic fracture fixation were independently related to gluteal necrosis. Conclusions Our non-selective bilateral iliac arterial embolization procedure involves arresting shock quickly, resulting in no post-procedure gluteal necrosis. The procedure involves cutting the gelatin sponge rather than “pumping” and avoids the use of vasopressors.

Uterine Arteriovenous Fistula:Rare Cause of Vaginal Bleeding and Experience from 14 Case Series in a Single Center

2020 ◽  
Author(s):  
Ruan fei ◽  
wu zaigui ◽  
zhou jianhong
Keyword(s):  
Vaginal Bleeding ◽  
Case Series ◽  
Arterial Embolization ◽  
Abnormal Uterine Bleeding ◽  
Time Interval ◽  
Artery Embolization ◽  
Dilation And Curettage ◽  
Products Of Conception ◽  
Ultrasound Findings ◽  
Internal Iliac

Abstract Background: This study aimed to summarize the characteristics of uterine arteriovenous fistul for proper treatment.Methods: This was a retrospective study of fourteen women diagnosed with uterine arteriovenous fistul and eventually proved by pelvic angiography at our department,. Results: Six women presented with late postpartum hemorrhage and the other seven had abnormal uterine bleeding while only one was asymptomatic.The majority of them had uterine manipulation with the most common being repeated dilation and curettage but the time interval ranged from more than ten days to months even several years. they could originate from ovarian artery or internal iliac artery in rare cases and even some cases showed uterine artery- ovarian vein fistul. Most of them had a good outcome with bleeding resolved or mild bleeding after arterial embolization with controllable fever and pain, and only three cases had surgery unsuitable for embolization or formation of traffic branch after embolization.Conclusions: uterine arteriovenous fistul were rare but easy to be diagnosed with characteristic ultrasound findings along medical history such as D&G and feature of vaginal bleeding. A successful treatment for artery embolization was based on careful evaluated vessels mapped by angiography while a comprehensive assessment with color and spectral flow Doppler was very necessary to exclude retained products of conception or placenta and avert unnecessary D&G after embolization. Surgical therapy was the last choice in women difficult to embolism or failed with UAE.

scholarly journals Transcatheter Artery Embolization for Postoperative Haemorrhage after Arterio-Venous Malformation – Safer Option

2021 ◽  
Vol 28 (1) ◽  
pp. 11
Author(s):  
Panda Subrat ◽  
Sharma Nalini ◽  
Khan Dina Aisha ◽  
Saha Anusmita ◽  
Das Rituparna ◽  
...  
Keyword(s):  
Internal Iliac Artery ◽  
Venous Malformation ◽  
Postoperative Bleeding ◽  
Artery Embolization ◽  
Iliac Arteries ◽  
Postoperative Haemorrhage ◽  
Internal Iliac ◽  
Av Malformation ◽  
Arterio Venous Malformation ◽  
The Right

Introduction: Hemorrhage is one of the commonest and dreaded complications especially with pelvic surgeries. Gestational trophoblastic neoplasias (GTN) are notorious for their propensity to bleed torrentially and metastasis to vital organs. GTN is associated with an arterio-venous malformation (AVM) about 10-15% of the time, which can lead to bleeding after surgery or after complete remission. After the failure of conventional management with chemotherapy or surgery one is compelled to take another modality of management. One of such methods is the use of transcatheter artery embolization in cases of GTN or post-hysterectomy cases of GTN. Transcatheter artery embolization (TAE) was effective in controlling bleeding due to arterio-venous malformation in 96% of cases.Case: 46 years P2L2A5 (para 2, living issue 2, abortion 5) post-hysterectomy patient presented with bleeding from the vagina after surgery. Twice she underwent vaginal vault repair after hysterectomy but failed. Ultrasonography (USG) showed arterio-venous malformation (AVM); angiography revealed massive extravasation from (left internal iliac artery and abnormal vascularity from the right internal iliac. She was taken up for bilateral internal iliac arteries embolization but again had a heavy bout of bleeding after one week. CT scan confirmed a residual lesion and she underwent a repeat embolization after which the bleeding stopped. Serum BHCG was advised during workup and it was 1997 IU/ml. A diagnosis of GTN was confirmed. The patient was discharged after two cycles of chemotherapy with advice to review for the third one on an outpatient department basis.Conclusion: We concluded that TAE is an effective and safer alternative to surgery in postoperative bleeding from AV malformation in the case of GTN. It can be repeated and should be made to more liberal use in emergency settings.

scholarly journals Letter to the Editor: Non-selective bilateral internal iliac artery embolization is a safe and effective way in hemorrhage control for hemodynamically unstable pelvic fractures

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hui Li ◽  
Ping Hu
Keyword(s):  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Pelvic Fractures ◽  
Pelvic Cavity ◽  
Artery Embolization ◽  
Contrast Extravasation ◽  
Contrast Enhanced Ct ◽  
Enhanced Ct ◽  
Internal Iliac ◽  
Internal Iliac Artery Embolization

AbstractA recently published article by Lai et al. in BMC Musculoskeletal Disorders trying to show that patients with pelvic fractures undergoing non-selective internal iliac artery embolization may lead to a higher rate of surgical site infection. The authors also noted that only a small percentage of patients with contrast extravasation detected by emergency contrast-enhanced CT were subsequently confirmed by angiography, thus, considered that the value of enhanced CT in predicting arterial injury was limited. The authors also believe that embolization of the main stem may cause incomplete hemostasis due to the abundant collateral circulations in the pelvic cavity. Although the author’s findings are mentioned in other studies, the article’s data and pictures only partially supported its inferences, and the conclusions cannot be drawn directly. In this Correspondence, we tried to reinterpret the additional findings in the article from our perspective. Through this discussion, we hope that more colleagues can re-understand the safety and effectiveness of non-selective internal iliac artery embolization in treating hemodynamically unstable pelvic fractures during the early resuscitation stage.

Sign in / Sign up

Export Citation Format

Share Document