Embolization of isolated lumbar artery injuries in trauma patients.
OBJECTIVE
The purpose of the study was to evaluate the angiographic findings and results of embolotherapy in the management of lumbar artery trauma.


METHODS
All patients with lumbar artery injury who underwent angiography and percutaneous embolization in a state trauma center within a 10-year period were retrospectively reviewed. Radiological information and procedural reports were reviewed to assess immediate angiographic findings and embolization results. Long-term clinical outcome was obtained by communication with the trauma physicians as well as with chart review.


RESULTS
In a 10-year period, 255 trauma patients underwent abdominal aortography. Eleven of these patients (three women and eight men) suffered a lumbar artery injury. Angiography demonstrated active extravasation (in nine) and/or pseudoaneurysm (in four). Successful selective embolization of abnormal vessel(s) was performed in all patients. Coils were used in six patients, particles in one and gelfoam in five patients. Complications included one retroperitoneal abscess, which was treated successfully. One patient returned for embolization of an adjacent lumbar artery due to late pseudoaneurysm formation.


CONCLUSIONS
In hemodynamically stable patients, selective embolization is a safe and effective method for immediate control of active extravasation, as well as to prevent future hemorrhage from an injured lumbar artery.
Sofocleous
Constantinos T
CT
Section of Vascular & Interventional, Department of Radiology, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, 150 Bergen St., Newark, New Jersey, 07103, USA. constant@pol.net
Hinrichs
Clay R
CR
Hubbi
Basil
B
Doddakashi
Satish
S
Bahramipour
Philip
P
Schubert
Johanna
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D017541:Aneurysm, False / Q000209:etiology / Q000628:therapy; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging; D001027:Aortography / Q000009:adverse effects; D001158:Arteries / Q000293:injuries; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome