Embolisation for Vascular Injuries Complicating Elective Orthopaedic Surgery

• Published in: European journal of vascular and endovascular surgery 2011-11, Vol.42 (5), p.676-683
• Main Authors: Mavrogenis, A.F, Rossi, G, Rimondi, E, Ruggieri, P, Mercuri, M
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Angiography; Elective Surgical Procedures - adverse effects; Embolisation; Embolization, Therapeutic; Enbucrilate - therapeutic use; Female; Humans; Male; Middle Aged; Orthopaedic surgery; Orthopedic Procedures - adverse effects; Patient Selection; Retrospective Studies; Surgery; Treatment Outcome; Vascular injuries; Vascular System Injuries - etiology; Vascular System Injuries - therapy; Young Adult
• ISSN: 1078-5884; 1532-2165
• DOI: 10.1016/j.ejvs.2011.04.009

Abstract Objectives The study aims to present the indications and emphasise the role of embolisation for vascular injuries in orthopaedic surgery. Methods Thirty-one patients with vascular injuries complicating elective orthopaedic surgery had embolisation from 2003 to 2010. N -2-butyl cyano-acrylate (NBCA) was used as embolic agent in 28 patients, gelatin sponge in three and coil embolisation in addition to NBCA or gelatin sponge in two patients. The mean follow-up period was 37 months (range, 4–96 months). Results The most common orthopaedic operations associated with vascular injuries amenable to embolisation were hip-joint procedures; and the most common injuries were arterial tears of branch vessels or non-critical axial vessels, most commonly of the superior glutaeal artery. In all cases, angiography showed the bleeding point, and a single embolisation session effectively stopped bleeding. Embolisation-related complications were not observed. Conclusions Embolisation should be considered the treatment of choice for vascular injuries of branch vessels or non-critical axial vessels following elective orthopaedic surgery because of the advantages of minimally invasive therapy and the lack of complications.