Nonoperative management with angioembolization for blunt abdominal solid organ trauma in hemodynamically unstable patients: a systematic review and meta-analysis

Purpose The objective of the present study is to provide a comprehensive review of the literature on associated outcomes of angioembolization in blunt abdominal solid organ traumas. Methods The databases of Medline, Embase, and Cochrane Library were explored until 24 September 2021. All studies with data on the efficacy or safety of angioembolization in patients suffering from hemodynamically unstable blunt abdominal solid organ trauma were included. The primary outcomes were clinical success rate and mortality. Pooled event rates were calculated using a double arcsine transformation to stabilize the variance of the original proportion. Results In total, 13 reports of 12 studies were included in the systematic review. According to the current meta-analysis, the angioembolization for blunt abdominal solid organ trauma in hemodynamically unstable patients had a high clinical success rate [0.97 (95% CI 0.93-0.99)] and low mortality [0.03 (95% CI 0.01-0.07)]. Furthermore, no statistically significant difference was found between the various injured solid organs for either of these parameters. In addition, the technique-associated adverse events were seldom and tolerable. Conclusions For blunt abdominal solid organ trauma in hemodynamically unstable patients, this review shows that angioembolization exhibited a high clinical success rate, low mortality, and tolerable technique-related adverse events. Furthermore, the top possible indication for angioembolization in hemodynamically unstable patients is an individual who responds to rapid fluid resuscitation. However, high-quality and large-scale trials are needed to confirm these results and determine the selection criteria for appropriate patients in this setting.