title: Transarterial embolization for the management of hemarthrosis of the knee.
abstract: BACKGROUND
  The purpose of this retrospective study was to evaluate transarterial catheter embolization (TAE) for the management of hemarthrosis of the knee in 35 patients treated at two different hospitals.
  
  
  METHODS
  From June 1998 through January 2011, 35 patients (22 men and 13 women, mean age 57 years) underwent TAE for hemarthrosis of the knee using polyvinyl alcohol particles (PVA particles), multi-curled 0.018 in. microcoils or a combination of both. In one patient a detachable microcoil was used. Hemarthrosis developed after arthroscopy in 9, after trauma in 3, after arthroplasty in 18 and after sepsis in 2 patients. 2 patients had severe gonarthrosis and in one patient hemarthrosis was due to Marfan's syndrome. Angiographies showed abnormal and increased vasculature in 23 patients, one or more pseudoaneurysms in 8 and arterio-venous fistula in 2 patients. One patient showed both, pseudoaneurysm and hypervascularization and another one pseudoaneurysm and arterio-venous fistula.
  
  
  RESULTS
  Technical success was achieved in 100%. None of the patients developed procedure-related complications such as periarticular skin- or tissue necrosis, including a patient who underwent TAE of two different bleeding sources in two consecutive sessions. Clinical success was 93.4%. Two patients showed recurrent swelling of the knee, 377 and 824 days after TAE respectively. However, only one of them required secondary TAE because of abnormal and increased vasculature.
  
  
  CONCLUSIONS
  In our view, TAE is the treatment of choice for the management of hemarthrosis of the knee. It is an effective and minimally invasive technique with very low complication rates.
authors.affiliation: Department of Radiology, Hospital of the Sisters of Charity, Linz, Austria. peter.waldenberger@bhs.at
authors.forename: P
authors.initials: P
authors.lastname: Waldenberger
authors.forename: A
authors.initials: A
authors.lastname: Chemelli
authors.forename: A
authors.initials: A
authors.lastname: Hennerbichler
authors.forename: M
authors.initials: M
authors.lastname: Wick
authors.forename: M C
authors.initials: MC
authors.lastname: Freund
authors.forename: W
authors.initials: W
authors.lastname: Jaschke
authors.forename: M
authors.initials: M
authors.lastname: Thaler
authors.forename: I E
authors.initials: IE
authors.lastname: Chemelli-Steingruber
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006395:Hemarthrosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D011142:Polyvinyl Alcohol / Q000627:therapeutic use*; D011859:Radiography; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D006490:Hemostatics; D011142:Polyvinyl Alcohol