Clinical Results of Distal Embolization in Grade V Splenic Injury: Four-Year Experience from a Single Regional Trauma Center

被引:14
作者
Lee, Rang [1 ]
Jeon, Chang Ho [1 ]
Kim, Chang Won [1 ]
Kwon, Hoon [1 ]
Kim, Jae Hun [2 ]
Kim, Hohyun [2 ]
Park, Sung Jin [2 ]
Kim, Gil Hwan [2 ]
Park, Chan Yong [3 ]
机构
[1] Pusan Natl Univ Hosp, Dept Radiol, 179 Gudeok Ro, Busan 49241, South Korea
[2] Pusan Natl Univ Hosp, Dept Trauma & Surg Crit Care, 179 Gudeok Ro, Busan 49241, South Korea
[3] Wonkwang Univ Hosp, Dept Trauma Surg, Jeollabuk Do, South Korea
关键词
TRANSCATHETER ARTERIAL EMBOLIZATION; NONOPERATIVE MANAGEMENT; ANGIOGRAPHY; SPLENECTOMY; ASSOCIATION; OUTCOMES; SURGERY; ADULTS; TRIAL;
D O I
10.1016/j.jvir.2020.01.029
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose: To evaluate the benefits and risks of splenic artery embolization (SAE) in patients with American Association for the Surgery of Trauma (AAST) grade V blunt spleen injury (BSI) Materials and Methods: Medical records of 88 patients treated with SAE between April 2013 and May 2017 at a regional trauma care center were reviewed retrospectively. The BSI grade according to the AAST spleen injury scale (revised version 2018) was determined by using computed tomography (CT) images. A total of 42 patients (46.6%) had AAST grade V injury and were included in the analysis. Patient demographics, angiographic findings, embolization techniques, and technical and clinical outcomes, including splenic salvage rate and procedure-related complications, were examined. Results: SAE was performed within 2 hours after admission for 78.5% of the patients. All patients underwent selective distal embolization (n = 42). Primary clinical success rate was 80.9% (n = 34), and secondary clinical success rate was 88.1% (n = 37). The clinical failure group consisted of 5 patients. Four patients underwent splenectomy, and 1 patient died due to acute respiratory distress syndrome after embolization. The splenic salvage rate was 85.7% (n = 36). No patient had sepsis at follow-up (median, 247.0 days; interquartile range, 92.0-688.0). Clinical success rates (P = .356) and spleen salvage rates (P = .197) of patients who were hemodynamically stable (n = 19) showed no significant differences from those who were unstable (n = 23). Conclusions: Distal embolization of grade V BSI is a safe and feasible procedure which is effective for successful spleen salvage.
引用
收藏
页码:1570 / +
页数:10
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