Application value of transcatheter intercostal artery embolization in patients with active hemothorax

LI Zhao-jun; DING Li-shan; CHEN Qing-liang; SHEN Meng; LIANG Hao; ZHENG Ming; MA Ji; LI Teng-fei

doi:10.13820/j.cnki.gdyx.20242514

Abstract：Objective To investigate the effectiveness and safety of transcatheter intercostal artery embolization(TAE)in the treatment of intercostal artery bleeding by using digital subtraction angiography(DSA)to locate and pre-cisely embolize occult bleeding sites.Methods A retrospective analysis was performed on 16 patients with intercostal ar-tery bleeding treated between December 2021 and December 2023 at the Department of Interventional Radiology,the Third People's Hospital of Henan Province,and the Interventional Treatment Center,the First Affiliated Hospital of Zhengzhou University.The cohort included 10 males and 6 females,aged 31-89 years,with a mean age of(59.00±18.31)years.Causes of injury included road traffic accidents(8 cases),fall injuries(5 cases),iatrogenic injury(1 case),and other traumas(2 cases).The severity and extent of intercostal artery injury were evaluated,and bleeding sites were identified using angiography.Hemostasis was achieved via precise embolization,and technical success rate,clinical success rate,and associated complications were recorded.Results A total of 39 responsible vessels were identified through angiogra-phy,all of which were intercostal arteries.Effective hemostasis was achieved in all 16 patients treated with TAE,resulting in an embolization success rate of 100％.Among the 16 patients,10 cases exhibited obvious extravasation of contrast a-gent,and 6 cases showed pseudoaneurysm formation.Gelatin sponge particles alone or combined with coils were used for embolization.The average hemoglobin level was significantly improved from preoperative levels to(105.30±4.21)g/L at 3 days postoperatively(t=9.74,P=0.013).During a 3-month follow-up,except for one patient lost to follow-up,there were no cases of recurrent bleeding,and postoperative adverse reactions were mild with no severe complications re-ported.Conclusion For intercostal artery bleeding unresponsive to non-surgical medical treatment,TAE provides effec-tive hemostasis with high safety,efficacy,and minimal invasiveness,making it highly valuable for clinical application.