Pushable springcoil embolization of pseudoaneurysms caused by gluteal stab injuries.
OBJECTIVE
To retrospectively review the outcomes of 21 patients with stab wounds to the gluteal region who underwent embolization for pseudoaneurysms causing active bleeding.


METHODS
Between 1997 and 2007, 3 superior gluteal artery, 2 inferior gluteal artery and 16 deep femoral artery muscular branch pseudoaneurysms detected by digital subtraction angiography were selectively catheterized with diagnostic catheters with hydrophilic coating and embolized with pushable springcoils. 17 of the 21 pseudoaneurysms were located in a distal end of an artery where outflow vessels could not be depicted. The other 4 lesions were side wall injuries which required the placement of coils distal and proximal to the injury site.


RESULTS
Embolization was successful in controlling the bleeding in all of the patients. 16 patients required 1 or 2 coils, 4 patients required 3 coils and 1 patient required 5 coils. 2 patients had femoral puncture site hematomas which resolved spontaneously. 2 patients required surgical evacuation of large gluteal hematomas following the embolization because of symptoms second to mass effect. There were no procedure related major complications or mortality.


CONCLUSIONS
Our experience demonstrates that pushable coil embolization is a relatively simple, effective and economic method for the embolization of pseudoaneurysms caused by penetrating gluteal injuries. Experimenting with other embolization materials does not seem to be justified.
Guven
Koray
K
Istanbul University, Istanbul Faculty of Medicine, Department of Radiology, Istanbul, Turkey. korayguven@yahoo.com
Rozanes
Izzet
I
Ucar
Adem
A
Poyanli
Arzu
A
Yanar
Hakan
H
Acunas
Bulent
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D002081:Buttocks / Q000000981:diagnostic imaging / Q000293:injuries*; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D014951:Wounds, Stab / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy*; D055815:Young Adult