Transcatheter arterial embolization for hemodynamically unstable traumatic hemothorax
WANG Ganggang
JIANG Liqiang
WANG Yun
REN Baosheng
LIU Kai
ZHAO Jinwei
Abstract：Objective To explore the clinical value of transcatheter arterial embolization(TAE)in the treatment of hemodynamically unstable traumatic hemothorax.Methods A retrospective analysis was conducted on the clinical data of 15 patients with hemodynamically unstable traumatic hemothorax who underwent TAE between April 2015 and December 2023 in changzhou second people's Hospital.All patients underwent preoperative CT and other related examinations to confirm the diagnosis and assess the injury.During the procedure,the responsible arteries were embolized.Postoperative follow-up continued until the patients were discharged or died in the hospital.Technical success was defined as successful catheterization to the responsible bleeding vessel and successful embolization treatment.Clinical success was defined as discharge after recovery without additional surgical interventions for hemostasis during hospitalization.Results A total of 15 patients were included,all of whom first underwent closed thoracic drainage.Fourteen patients underwent TAE directly,while 1 patient underwent TAE after the failure of surgical hemostasis.Angiography showed varying degrees of contrast extravasation from the intercostal arteries in all patients.Among them,6 cases were complicated with pseudoaneurysms,1 case showed contrast extravasation from the L1 and L2 arteries,and 2 cases showed contrast extravasation from the internal iliac artery.The number of embolized arteries ranged from 1 to 7,with an average of 5.Two patients underwent embolization of the anterior intercostal artery.The technical success rate was 100％,and the clinical success rate was 66.7％.There were 5 deaths,resulting in a mortality rate of 33.3％,including 1 death due to severe craniocerebral injury,2 due to multiple organ failure,and 2 due to disseminated intravascular coagulation.No serious embolization-related complications were observed.Conclusion TAE for the treatment of hemodynamically unstable traumatic hemothorax offers the advantages of being minimally invasive and providing effective hemostasis,making it a safe and effective treatment method.
Keywords：traumatic hemothoraxchest traumarib fractureintercostal arteryembolization
Publication Date：2024-12-20
Online Publishing Date：2026-01-26(First online date of this platform, not the publication date of the document)
Pages：6( 24-29 )