CT-guided aortic balloon occlusion in traumatic abdominal and pelvic bleeding

被引:0
作者
Linsenmaier, U
Kanz, KG
Rieger, J
Krötz, M
Mutschler, W
Pfeifer, KJ
Reiser, M
机构
[1] Univ Munich, Klinikum Innenstadt, Inst Klin Radiol, D-8000 Munich, Germany
[2] Univ Munich, Klinikum Innenstadt, Chirurg Klin, D-8000 Munich, Germany
来源
ROFO-FORTSCHRITTE AUF DEM GEBIET DER RONTGENSTRAHLEN UND DER BILDGEBENDEN VERFAHREN | 2003年 / 175卷 / 09期
关键词
balloon occlusion; aorta; bleeding; hemorrhage; computed tomography; CT guided; multiple trauma;
D O I
暂无
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 introduce a new interventional method for CT-guided aortic balloon occlusion in patients with life-threatening abdominal or pelvic bleeding. Materials and Methods: Three male patients (age 18, 30, and 45 years) with multiple trauma underwent CT-guided balloon occlusion of the aorta after CT identified an active abdominal or pelvic bleeding site and the patients became unstable (systolic blood pressure, BP < 80 mm Hg) despite resuscitation continuous volume. Using a right femoral approach, a 9F sheath was immediately introduced and the positions of the guide wire and balloon catheter (20 x 40 mm) were intermittently checked with CT scans and CT fluoroscopy. In one case, a C-clamp was applied to the pelvic ring under CT guidance for emergency stabilization of an unstable pelvic fracture. Results: CT-guided aortic balloon occlusion and the mounting of the pelvic C-clamp were technically successful. Intervention time was 4 to 6 minutes for aortic balloon occlusion. All patients became at least temporarily stable hemodynamically with the blood pressure rising above 100 mmHg. The infrarenal occlusion catheters were left in place up to 60 minutes. Suprarenal occlusion was not performed. Two patients died due to protracted shock and complex injuries (injury severity score (ISS: 50 - 64). Conclusion: CT-guided aortic occlusion provides fast and effective bleeding control immediately after completion of the diagnostic CT. The procedure can be combined with other specific emergency surgical or interventional procedures. Experience with more patients is necessary for further evaluation of this new technique.
引用
收藏
页码:1259 / 1263
页数:5
相关论文
共 22 条
[1]  
BUHREN V, 1989, UNFALLCHIRURG, V92, P309
[2]   HEMODYNAMIC-EFFECTS OF AORTIC OCCLUSION DURING HEMORRHAGIC-SHOCK [J].
DUNN, EL ;
MOORE, EE ;
MOORE, JB .
ANNALS OF EMERGENCY MEDICINE, 1982, 11 (05) :238-241
[3]  
EDWARDS WS, 1953, SURG FORUM, V4, P496
[4]  
Greenberg RK, 2000, J ENDOVASC THER, V7, P1, DOI 10.1583/1545-1550(2000)007<0001:AEMOHC>2.3.CO
[5]  
2
[6]   THE ROLE OF INTRA-AORTIC BALLOON OCCLUSION IN PENETRATING ABDOMINAL-TRAUMA [J].
GUPTA, BK ;
KHANEJA, SC ;
FLORES, L ;
EASTLICK, L ;
LONGMORE, W ;
SHAFTAN, GW .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1989, 29 (06) :861-865
[7]  
HUGHES CW, 1954, SURGERY, V36, P65
[8]  
Kanz KG, 2002, RADIOLOGE, V42, P515, DOI 10.1007/s00117-002-0769-3
[9]   ROLE OF THORACIC AORTIC OCCLUSION FOR MASSIVE HEMOPERITONEUM [J].
LEDGERWOOD, AM ;
KAZMERS, M ;
LUCAS, CE .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1976, 16 (08) :610-615
[10]   Whole-body computed tomography in polytrauma:: techniques and management [J].
Linsenmaier, U ;
Krötz, M ;
Häuser, H ;
Rock, C ;
Rieger, J ;
Bohndorf, K ;
Pfeifer, KJ ;
Reiser, M .
EUROPEAN RADIOLOGY, 2002, 12 (07) :1728-1740