[Treatment options for perioperative hemorrhage: interventional angiography to control bleeding complications after total hip arthroplasty].
Perioperative hemorrhage after total hip arthroplasty is a rare but life-threatening complication. The aim of the current retrospective analysis of five cases was to answer the question of whether bleeding can be controlled by angiography and catheter embolization.A retrospective analysis of five patients with perioperative bleeding complications after hip surgery was done. Bleeding occurred in one case after implantation of an acetabular revision cup, in three cases in association with implantation of a bipolar prosthesis, and in one case in conjunction with a Girdlestone procedure due to septic femoral head necrosis. In four cases we detected arterial bleeding with angiography, all of which were controlled during angiography; one case was complicated by bleeding after a few days. One patient died from multiorgan failure after control of peracute hemorrhage. Subacute hemorrhage after hip surgery can be controlled by angiography. In peracute situations clamping of the external iliac artery is an alternative procedure.
Helwig
P
P
Department Orthopädie und Traumatologie, Universitätsklinik, Albert-Ludwigs-Universität, Hugstetterstrasse 55, 79106 Freiburg. peter.helwig@uniklinik-freiburg.de
Uhl
M
M
Niemeyer
P
P
Strohm
P C
PC
Südkamp
N P
NP
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D021721:Balloon Occlusion / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D019990:Perioperative Care / Q000379:methods*; D019106:Postoperative Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000628:therapy*; D015641:Radiography, Interventional / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome