title: Endovascular treatment in emergency setting of acute arterial injuries after orthopedic surgery.
abstract: OBJECTIVE
  To assess the feasibility and effectiveness of emergency endovascular treatment of acute arterial injuries after orthopedic surgery.
  
  
  METHODS
  Fifteen patients (mean age 68.3 years) with acute arterial injuries after orthopedic surgery were observed, in particular, 5 patients with pseudoaneurysm, 9 patients with active bleeding, and 1 patient with arterial dissection. Transarterial embolization (TAE) and positioning of covered and noncovered stents were the treatments performed. Follow-up after stent implantation (mean 36 months) was performed with color Doppler US (CDU) at 1, 3, 6, and 12 months and yearly thereafter. Plain X-ray was performed to evidence dislodgment or fracture of the graft. A minimum of 12 months' follow-up is available after TAE.
  
  
  RESULTS
  Immediate technical success was obtained in all cases. No major complications occurred. Overall clinical success rate was 100%. During mean follow-up, stent-graft occlusions did not occurred. No recurrence and/or consequence of TAE was registered during a minimum follow-up of 12 months.
  
  
  CONCLUSIONS
  Percutaneous treatment is a feasible and safe tool for treating arterial injuries because it can provide fast and definitive resolution of the damage. This low-invasiveness approach can be proposed as first-line treatment in patients with acute injuries after orthopedic surgery.
authors.affiliation: Interventional Radiology, Department of Radiology, Insubria University, 57, 21100, Varese, Italy. gcarraf@tin.it
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Carrafiello
authors.forename: Federico
authors.initials: F
authors.lastname: Fontana
authors.forename: Monica
authors.initials: M
authors.lastname: Mangini
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Ierardi
authors.forename: Domenico
authors.initials: D
authors.lastname: Laganà
authors.forename: Filippo
authors.initials: F
authors.lastname: Piacentino
authors.forename: Francesco Alberto
authors.initials: FA
authors.lastname: Vizzari
authors.forename: Emanuela
authors.initials: E
authors.lastname: Spanò
authors.forename: Carlo
authors.initials: C
authors.lastname: Fugazzola
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000628:therapy*; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000628:therapy*; D000792:Angiography; D001158:Arteries / Q000293:injuries*; D003287:Contrast Media; D004638:Emergency Treatment; D057510:Endovascular Procedures; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007479:Iopamidol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy*; D012189:Retrospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014283:Triiodobenzoic Acids; D018615:Ultrasonography, Doppler, Color
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C057937:iomeprol; C044834:iodixanol; D007479:Iopamidol