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Shreve L, Jarmakani M, Javan H, et al. Endovascular management of traumatic pseudoaneurysms. CVIR Endovasc. 2020;3(1):88doi: 10.1186/s42155-020-00182-7.
Shreve, L., Jarmakani, M., Javan, H., Babin, I., Nelson, K., Katrivesis, J., Lekawa, M., Kuncir, E., Fernando, D., & Abi-Jaoudeh, N. (2020). Endovascular management of traumatic pseudoaneurysms. CVIR endovascular, 3(1), 88. https://doi.org/10.1186/s42155-020-00182-7
Shreve, Lauren, et al. "Endovascular management of traumatic pseudoaneurysms." CVIR endovascular vol. 3,1 (2020): 88. doi: https://doi.org/10.1186/s42155-020-00182-7
Shreve L, Jarmakani M, Javan H, Babin I, Nelson K, Katrivesis J, Lekawa M, Kuncir E, Fernando D, Abi-Jaoudeh N. Endovascular management of traumatic pseudoaneurysms. CVIR Endovasc. 2020 Nov 27;3(1):88. doi: 10.1186/s42155-020-00182-7. PMID: 33245433; PMCID: PMC7695774.
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CVIR Endovasc. 2020 Nov 27;3(1):88. doi: 10.1186/s42155-020-00182-7.

Endovascular management of traumatic pseudoaneurysms.

CVIR endovascular

Lauren Shreve, Maha Jarmakani, Hanna Javan, Ivan Babin, Kari Nelson, James Katrivesis, Michael Lekawa, Eric Kuncir, Dayantha Fernando, Nadine Abi-Jaoudeh

Affiliations

  1. Department of Radiological Sciences, University of California, Irvine, 101 The City Drive South, Rm 115 Rte 140, Orange, CA, 92868, USA.
  2. Department of Trauma Surgery, University of California, Irvine, Irvine, California, USA.
  3. Department of Radiological Sciences, University of California, Irvine, 101 The City Drive South, Rm 115 Rte 140, Orange, CA, 92868, USA. [email protected].

PMID: 33245433 PMCID: PMC7695774 DOI: 10.1186/s42155-020-00182-7

Abstract

BACKGROUND: Pseudoaneurysms (PAs) caused by traumatic injury to the arterial vasculature have a high risk of rupture, leading to life-threatening hemorrhage and mortality, requiring urgent treatment. The purpose of this study was to determine the technical and clinical outcomes of endovascular treatment of visceral and extremity traumatic pseudoaneurysms.

METHODS: Clinical data were retrospectively collected from all patients presenting for endovascular treatment of PAs between September 2012 and September 2018 at a single academic level one trauma center. Technical success was defined as successful treatment of the PA with no residual filling on post-embolization angiogram. Clinical success was defined as technical successful treatment with no rebleeding throughout the follow-up period and no reintervention for the PA.

RESULTS: Thirty-five patients (10F/25M), average age (± stdev) 41.7 ± 20.1 years, presented with PAs secondary to blunt (n = 31) or penetrating (n = 4) trauma. Time from trauma to intervention ranged from 2 h - 75 days (median: 4.4 h, IQR: 3.5-17.1 h) with 27 (77%) of PAs identified and treated within 24 h of trauma. Average hospitalization was 13.78 ± 13.4 days. Ten patients underwent surgery prior to intervention. PA number per patient ranged from 1 to 5 (multiple diffuse). PAs were located on the splenic (n = 12, 34.3%), pelvic (n = 11, 31.4%), hepatic (n = 9, 25.7%), upper extremity/axilla (n = 2, 5.7%), and renal arteries (n = 1, 2.9%). Technical success was 85.7%. Clinical success was 71.4%, for technical failure (n = 5), repeat embolization (n = 1) or post-IR surgical intervention (n = 4). There was no PA rebleeding or reintervention for any patient after discharge over the reported follow-up periods. Three patients died during the trauma hospitalization for reasons unrelated to the PAs.

CONCLUSIONS: Endovascular treatment of traumatic visceral and extremity PAs is efficacious with minimal complication rates and low reintervention requirements.

Keywords: Endovascular treatment; Pseudoaneurysm; Trauma

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