Vascular Trauma

Embolisation for Vascular Injuries Complicating Elective Orthopaedic Surgery

Mavrogenis AF, Rossi G, Rimondi E, et al (Univ of Bologna, Italy; Istituto Ortopedico Rizzoli, Italy) Eur J Vasc Endovasc Surg 42:676–683, 2011^§

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.

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