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Transcatheter Arterial Embolization for Bleeding Related to Pelvic Trauma: Comparison of Technical and Clinical Results between Hemodynamically Stable and Unstable Patients

Background: Endovascular intervention is now the primary line of therapy for arterial injury brought on by pelvic trauma since it can significantly reduce considerable morbidity associated with surgery and can swiftly access and control bleeding sites. Despite international guidelines and widespread...

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Autores principales: Minici, Roberto, Mercurio, Michele, Guzzardi, Giuseppe, Venturini, Massimo, Fontana, Federico, Brunese, Luca, Guerriero, Pasquale, Serra, Raffaele, Piacentino, Filippo, Spinetta, Marco, Zappia, Lorenzo, Costa, Davide, Coppola, Andrea, Galasso, Olimpio, Laganà, Domenico
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10514840/
https://www.ncbi.nlm.nih.gov/pubmed/37736986
http://dx.doi.org/10.3390/tomography9050133
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author Minici, Roberto
Mercurio, Michele
Guzzardi, Giuseppe
Venturini, Massimo
Fontana, Federico
Brunese, Luca
Guerriero, Pasquale
Serra, Raffaele
Piacentino, Filippo
Spinetta, Marco
Zappia, Lorenzo
Costa, Davide
Coppola, Andrea
Galasso, Olimpio
Laganà, Domenico
author_facet Minici, Roberto
Mercurio, Michele
Guzzardi, Giuseppe
Venturini, Massimo
Fontana, Federico
Brunese, Luca
Guerriero, Pasquale
Serra, Raffaele
Piacentino, Filippo
Spinetta, Marco
Zappia, Lorenzo
Costa, Davide
Coppola, Andrea
Galasso, Olimpio
Laganà, Domenico
author_sort Minici, Roberto
collection PubMed
description Background: Endovascular intervention is now the primary line of therapy for arterial injury brought on by pelvic trauma since it can significantly reduce considerable morbidity associated with surgery and can swiftly access and control bleeding sites. Despite international guidelines and widespread awareness of the role of angioembolization in clinical practice, robust evidence comparing the outcomes of angioembolization in hemodynamically stable and unstable patients is still lacking. This study aims to directly compare the outcomes of angioembolization for the treatment of pelvic traumatic arterial injury in patients with hemodynamic stability vs. hemodynamic instability. Methods: In our multicenter retrospective investigation, we analyzed data from consecutive patients who underwent, from January 2020 to May 2023, angioembolization for traumatic pelvic arterial injury. Results: In total, 116 angioembolizations were performed. Gelatin sponges (56.9%) and coils (25.9%) were the most widely used embolic agents. The technical and clinical success rates were 100% and 91.4%, respectively. No statistically significant differences were observed between the two groups in terms of technical success, clinical success, procedure-related complication rate, or 30-day bleeding-related mortality. Conclusions: Angioembolization is an effective and safe option for the management of traumatic pelvic arterial lesions even in hemodynamically unstable patients, despite technical variations such as greater use of prophylactic angioembolization.
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spelling pubmed-105148402023-09-23 Transcatheter Arterial Embolization for Bleeding Related to Pelvic Trauma: Comparison of Technical and Clinical Results between Hemodynamically Stable and Unstable Patients Minici, Roberto Mercurio, Michele Guzzardi, Giuseppe Venturini, Massimo Fontana, Federico Brunese, Luca Guerriero, Pasquale Serra, Raffaele Piacentino, Filippo Spinetta, Marco Zappia, Lorenzo Costa, Davide Coppola, Andrea Galasso, Olimpio Laganà, Domenico Tomography Article Background: Endovascular intervention is now the primary line of therapy for arterial injury brought on by pelvic trauma since it can significantly reduce considerable morbidity associated with surgery and can swiftly access and control bleeding sites. Despite international guidelines and widespread awareness of the role of angioembolization in clinical practice, robust evidence comparing the outcomes of angioembolization in hemodynamically stable and unstable patients is still lacking. This study aims to directly compare the outcomes of angioembolization for the treatment of pelvic traumatic arterial injury in patients with hemodynamic stability vs. hemodynamic instability. Methods: In our multicenter retrospective investigation, we analyzed data from consecutive patients who underwent, from January 2020 to May 2023, angioembolization for traumatic pelvic arterial injury. Results: In total, 116 angioembolizations were performed. Gelatin sponges (56.9%) and coils (25.9%) were the most widely used embolic agents. The technical and clinical success rates were 100% and 91.4%, respectively. No statistically significant differences were observed between the two groups in terms of technical success, clinical success, procedure-related complication rate, or 30-day bleeding-related mortality. Conclusions: Angioembolization is an effective and safe option for the management of traumatic pelvic arterial lesions even in hemodynamically unstable patients, despite technical variations such as greater use of prophylactic angioembolization. MDPI 2023-09-01 /pmc/articles/PMC10514840/ /pubmed/37736986 http://dx.doi.org/10.3390/tomography9050133 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Minici, Roberto
Mercurio, Michele
Guzzardi, Giuseppe
Venturini, Massimo
Fontana, Federico
Brunese, Luca
Guerriero, Pasquale
Serra, Raffaele
Piacentino, Filippo
Spinetta, Marco
Zappia, Lorenzo
Costa, Davide
Coppola, Andrea
Galasso, Olimpio
Laganà, Domenico
Transcatheter Arterial Embolization for Bleeding Related to Pelvic Trauma: Comparison of Technical and Clinical Results between Hemodynamically Stable and Unstable Patients
title Transcatheter Arterial Embolization for Bleeding Related to Pelvic Trauma: Comparison of Technical and Clinical Results between Hemodynamically Stable and Unstable Patients
title_full Transcatheter Arterial Embolization for Bleeding Related to Pelvic Trauma: Comparison of Technical and Clinical Results between Hemodynamically Stable and Unstable Patients
title_fullStr Transcatheter Arterial Embolization for Bleeding Related to Pelvic Trauma: Comparison of Technical and Clinical Results between Hemodynamically Stable and Unstable Patients
title_full_unstemmed Transcatheter Arterial Embolization for Bleeding Related to Pelvic Trauma: Comparison of Technical and Clinical Results between Hemodynamically Stable and Unstable Patients
title_short Transcatheter Arterial Embolization for Bleeding Related to Pelvic Trauma: Comparison of Technical and Clinical Results between Hemodynamically Stable and Unstable Patients
title_sort transcatheter arterial embolization for bleeding related to pelvic trauma: comparison of technical and clinical results between hemodynamically stable and unstable patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10514840/
https://www.ncbi.nlm.nih.gov/pubmed/37736986
http://dx.doi.org/10.3390/tomography9050133
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