title: Management of complicated lumbar artery injury after blunt trauma.
abstract: OBJECTIVE
  Lumbar artery injury after blunt trauma is not frequently discussed. We review our experience with blunt lumbar artery injury management, especially alternative treatments in which embolization is not feasible.
  
  
  METHODS
  We reviewed our trauma registry for 8 years 8 months. We sought all patients who sustained blunt torso trauma and had lumbar artery injury detected by angiography. Variables collected included demographic data, trauma mechanism, vital signs in triage, Injury Severity Score, associated injuries, computed tomography results, angiography results, embolizations, and outcome.
  
  
  RESULTS
  Sixteen of the 3,436 patients in the trauma registry system had a blunt lumbar artery injury verified by angiography. For patients with lumbar artery injury, the mean Injury Severity Score was 38.6 (SD 12), and 10 (63%) of these 16 patients were in shock and 12 patients (75%) had closed head injuries. Angioembolization caused bleeding cessation in 11 patients but failed in 5 patients, who were treated conservatively. The overall mortality rate of patients with lumbar artery injury was 50%.
  
  
  CONCLUSIONS
  Lumbar artery injury in multiply injured patients with blunt trauma leads to a high mortality rate, especially if accompanied by head injury. Embolization often stops bleeding, but, if embolization is not feasible, conservative treatment without retroperitoneal surgery can be successful.
authors.affiliation: Trauma and Critical Care Center, Division of General Surgery, Department of Surgery, Chang-Gung Memorial Hospital, Chang-Gung University, Linko, Taiwan. traumayuan@gmail.com
authors.forename: Kuo-Ching
authors.initials: KC
authors.lastname: Yuan
authors.forename: Yu-Pao
authors.initials: YP
authors.lastname: Hsu
authors.forename: Yon-Cheong
authors.initials: YC
authors.lastname: Wong
authors.forename: Jen-Feng
authors.initials: JF
authors.lastname: Fang
authors.forename: Being-Chung
authors.initials: BC
authors.lastname: Lin
authors.forename: Huan-Wu
authors.initials: HW
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000293:injuries; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008161:Lumbosacral Region / Q000098:blood supply* / Q000293:injuries; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000628:therapy*; D055815:Young Adult