Abstract
Purpose:
The purpose of this study was to evaluate the effectiveness of percutaneous arterial embolization in patients with penetrating peripheral arterial trauma.
Materials and Methods:
Twelve patients with penetrating peripheral arterial trauma were treated with percutaneous arterial embolization between 2002 and 2007. All injuries were secondary to penetrating stab wounds. Active bleeding (eight patients), recurrent bleeding episodes (one patient), persistent pain and mass (one patient), leg edema, claudication, swelling (one patient), local hyperemia, and pain (one patient) were the presenting symptoms. Microcatheter systems were used for catheterization. We used n-butyl cyanoacrylate mixture as the embolizing agent in all patients.
Results:
On angiograms the inferior gluteal artery (one patient), internal pudendal artery (one patient), perforating branch of the profundal femoral artery (six patients), superficial femoral artery (one patient), peroneal artery (two patients), and anterior tibial artery (one patient) were found to be injured. In all patients, the source of arterial bleeding could be reached, and a safe embolization was achieved. Nontarget embolization due to backflow of n-butyl cyanoacrylate mixture was detected in two patients and inguinal hematoma at the puncture site occurred in one patient.
Conclusions:
We conclude that embolization—particularly n-butyl cyanoacrylate embolization—is technically feasible in patients with penetrating peripheral arterial trauma.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Velmahos GC, Demetriades D, Chahwan S, et al. (1999) Angiographic embolization for arrest of bleeding after penetrating trauma to the abdomen. Am J Surg 178:367–373
Panetta T, Sclafani SJ, Goldstein AS, Phillips TF (1985) Percutaneous transcatheter embolization for arterial trauma. J Vasc Surg 2:54–56
Parodi JC, Schonholz C, Ferreira LM, Bergan J (1999) Endovascular stent-graft treatment of traumatic arterial lesions. Ann Vasc Surg 13:121–129
Moore HM, List A, Holden A, Osborne TM (2000) Therapeutic embolization for acute haemorrhage in the abdomen and pelvis. Australas Radiol 44:161–168
McMillan WD, Smith ND, Nemcek A Jr, Pearce WH (1997) Transcatheter embolization of a ruptured superior gluteal artery aneurysm: case report and review of the literature. Endovasc Surg 4:376–379
Aksoy M, Taviloglu K, Yanar H, et al. (2005) Percutaneous transcatheter embolization in arterial injuries of the lower limbs. Acta Radiol 46:471–475
Kish JW, Katz MD, Marx MV, Harrell DS, Hanks SE (2004) N-Butyl cyanoacrylate embolization for control of acute arterial hemorrhage. J Vasc Interv Radiol 15:689–695
Lund JM, Clarke JM, Cockburn JF (2002) Medial circumflex femoral artery pseudoaneurysm following total hip replacement treated by coil embolisation. Eur J Vasc Endovasc Surg 24:182–183
Schoder M, Cejna M, Langle F, Hittmaier K, Lammer J (2000) Glue embolization of a ruptured celiac trunk pseudoaneurysm via the gastroduodenal artery. Eur Radiol 10:1335–1337
Yamakado K, Nakatsuka A, Tanaka N, Takano K, Matsumura K, Takeda K (2000) Transcatheter arterial embolization of ruptured pseudoaneurysms with coils and n-butyl cyanoacrylate. J Vasc Interv Radiol 11:66–72
Naidoo NM, Corr PD, Robbs JV, Maharaj J, Nair R (2000) Angiographic embolisation in arterial trauma. Eur J Vasc Endovasc Surg 19:77–81
Cantasdemir M, Adaletli I, Cebi D, Kantarci F, Selcuk ND, Numan F (2003) Emergency endovascular embolization of traumatic intrarenal arterial pseudoaneurysms with N-butyl cyanoacrylate. Clin Radiol 58:560–565
Baere T, Ousehal A, Kuoch V, Sapoval M, Lagrange C, Roche A (1998) Endovascular management of bleeding iliac artery pseudoaneurysms complicating radiation therapy for pelvic malignancies. AJR 170:349–353
Criado E, Marston WA, Ligush J, Mauro MA, Keagy BA (1997) Endovascular repair of peripheral aneurysms, pseudoaneurysms, and arteriovenous fistulas. Ann Vasc Surg.; 11:256–263
Onal B, Ilgit ET, Kosar S, Akkan K, Gumus T, Akpek S (2005) Endovascular treatment of peripheral vascular lesions with stent-grafts. Diagn Interv Radiol 11:170–174
Stahnke M, Duddy MJ (2006) Endovascular repair of a traumatic axillary pseudoaneurysm following anterior shoulder dislocation. Cardiovasc Interv Radiol 29:298–301
Ariyoshi H, Miyaso S, Aono Y, Kawasaki T, Sakon M, Monden M (2001) Delayed presentation of superficial femoral artery injury: report of a case. Surg Today 31:471–473
Woolgar JD, Reddy DS, Robbs JV (2002) Delayed presentation of traumatic popliteal artery pseudoaneurysms: a review of seven cases. Eur J Vasc Endovasc Surg 23:255–259
Nicholson AA (2004) Vascular radiology in trauma. Cardiovasc Interv Radiol 27:105–120
Teng MM, Chen CC, Lirng JF, Chen SS, Lee LS, Chang T (1994) N-Butyl-2-cyanoacrylate for embolisation of carotid aneurysm. Neuroradiology 36:144–147
Debrun GM, Aletich V, Ausman JI, Charbel F, Dujovny M (1997) Embolization of the nidus of brain arteriovenous malformations with n-butyl cyanoacrylate. Neurosurgery 40:112–120
Pollak JS, White RI Jr (2001) The use of cyanoacrylate adhesives in peripheral embolization. J Vasc Interv Radiol 12:907–913
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mavili, E., Donmez, H., Ozcan, N. et al. Endovascular Treatment of Lower Limb Penetrating Arterial Traumas. Cardiovasc Intervent Radiol 30, 1124–1129 (2007). https://doi.org/10.1007/s00270-007-9142-2
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00270-007-9142-2