title: Microcatheter embolization of non-neurologic traumatic vascular lesions.
abstract: OBJECTIVE
  The authors report their experience over a 28-month period with embolization of 23 non-neurologic traumatic vascular lesions in 21 patients with use of a coaxial microcatheter coil delivery system.
  
  
  METHODS
  The injuries included pseudoaneurysms (n = 17), arteriovenous fistulas (n = 3), and sites of extravasation (n = 3) and were caused by gunshot, shotgun, and stab wounds, as well as motor vehicle accidents and iatrogenic trauma. All microcatheter embolizations except one were performed with 2.2-F Tracker-18 catheters inserted coaxially through 5.0-5.5-F guiding catheters. In one case, a coaxial 3-F Teflon catheter was used. In all cases platinum microcoils (almost all non-fibril) and/or straight platinum embolization wires (with fibrils) were used.
  
  
  RESULTS
  Twenty-one (91%) of 23 vascular lesions were successfully occluded with use of the microcatheter system. The two cases in which microcatheter embolization failed were successfully managed by using larger catheters and steel coils. Two patients with hepatic vascular lesions (one site of extravasation and a pseudoaneurysm) and one patient with a lower extremity arteriovenous fistula required two procedures each for successful treatment. Procedures were life-saving in at least two patients. Two lesions recurred during follow-up ranging from 3 days to 17 months. Both of these recurrences were successfully treated with transcatheter embolization, in one case with use of microcatheters.
  
  
  CONCLUSIONS
  Microcatheter embolization with platinum coils and wires is an effective means for treating traumatic vascular lesions. A coaxial microcatheter system allows for easier, more rapid coil/wire delivery to smaller, spasm-prone arteries in such cases.
authors.affiliation: Department of Radiology LAC + USC Medical Center 90033.
authors.forename: G P
authors.initials: GP
authors.lastname: Teitelbaum
authors.forename: R A
authors.initials: RA
authors.lastname: Reed
authors.forename: D
authors.initials: D
authors.lastname: Larsen
authors.forename: R K
authors.initials: RK
authors.lastname: Lee
authors.forename: M J
authors.initials: MJ
authors.lastname: Pentecost
authors.forename: E J
authors.initials: EJ
authors.lastname: Finck
authors.forename: M D
authors.initials: MD
authors.lastname: Katz
mesh_terms: D000328:Adult; D017541:Aneurysm, False / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D001164:Arteriovenous Fistula / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D001808:Blood Vessels / Q000293:injuries*; D002404:Catheterization / Q000295:instrumentation* / Q000379:methods; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010984:Platinum; D013997:Time Factors; D014950:Wounds, Penetrating / Q000150:complications*
chemical_list: D010984:Platinum