title: Emergent transcatheter arterial embolization in hemodynamically unstable patients with blunt splenic injury.
abstract: OBJECTIVE
  Splenic preservation is currently the trend for treatment of patients with splenic trauma to avoid complications of splenectomy. This study aimed to evaluate the feasibility of emergent transcatheter arterial embolization (TAE) for hemodynamically unstable patients with blunt splenic injury.
  
  
  METHODS
  In a period of 2 years, 65 patients of blunt splenic trauma were studied. Patients with initial systolic blood pressure < 90 mmHg and showed initial response including rapid response and transient response to the emergent fluid resuscitation were included. Angiography and TAE was undertaken if contrast medium extravasation or pseudoaneurysm formation was noted in the computed tomography (CT) images, according to the criteria of American Association for the Surgery of Trauma. All patients who underwent TAE were admitted for observation of the possibility of delayed rupture.
  
  
  RESULTS
  Thirteen hemodynamically unstable patients who were responsive to initial fluid resuscitation received angiography due to abnormal CT findings including contrast agent extravasation in 12 patients, 2 patients with arteriovenous fistula, and 8 patients with pseudoaneurysm formation. TAE was successfully performed in all of these 13 patients, including 2 patients with associated left renal injuries and 1 patient associated with bilateral internal mammary arteries injuries, without complications.
  
  
  CONCLUSIONS
  TAE is a safe and effective procedure for treating blunt splenic injury even in hemodynamically unstable patients who responded to initial fluid resuscitation.
authors.affiliation: Department of Radiology, China Medical University Hospital, No 2, Yuh-Der Road, Taichung, 40406, Taiwan, ROC.
authors.forename: Wei-Ching
authors.initials: WC
authors.lastname: Lin
authors.forename: Yung-Fang
authors.initials: YF
authors.lastname: Chen
authors.forename: Chien-Heng
authors.initials: CH
authors.lastname: Lin
authors.forename: Yuan-Hong
authors.initials: YH
authors.lastname: Tzeng
authors.forename: Hsein-Jar
authors.initials: HJ
authors.lastname: Chiang
authors.forename: Yung-Jen
authors.initials: YJ
authors.lastname: Ho
authors.forename: Wu-Chung
authors.initials: WC
authors.lastname: Shen
authors.forename: Jeon-Hor
authors.initials: JH
authors.lastname: Chen
mesh_terms: D000328:Adult; D000792:Angiography; D003287:Contrast Media; D004621:Embolization, Therapeutic / Q000379:methods*; D005119:Extravasation of Diagnostic and Therapeutic Materials; D005240:Feasibility Studies; D005260:Female; D005440:Fluid Therapy; D006439:Hemodynamics; D006801:Humans; D008297:Male; D011379:Prognosis; D015641:Radiography, Interventional; D013154:Spleen / Q000000981:diagnostic imaging / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000628:therapy*
chemical_list: D003287:Contrast Media