title: Value of percutaneous embolotherapy for the management of traumatic vascular limb injury.
abstract: BACKGROUND
  Arterial injuries to the extremities may result in severe hemorrhagic complications. Open surgical repair has been the standard of care for these patients, but endovascular management may be a valuable, less invasive alternative.
  
  
  OBJECTIVE
  To evaluate the safety, efficacy and long-term durability of embolotherapy for the management of hemorrhagic, traumatic vascular injuries in upper and lower limbs.
  
  
  METHODS
  Patients with traumatic or iatrogenic hemorrhagic vascular injuries to the extremities and managed with endovascular embolotherapy in the authors' institution between 1998 and 2010 were included in this retrospective study. Embolization was performed with different embolic materials; technical and long-term clinical outcome was assessed by review of the medical records or by telephone interviews of the referring physicians.
  
  
  RESULTS
  Embolization was performed in 31 patients. In six patients the vascular lesion was traumatic, in the remaining 25 patients the lesion was of iatrogenic origin. Angiographic vascular lesions identified were: contrast extravasation (n = 19, 61%), pseudoaneurysm (n = 8, 26%), and pseudoaneurysm with arteriovenous fistula (n = 3, 10%). Primary and secondary clinical success was obtained in 84% and 97% of cases, respectively. Procedure-related complications occurred in five patients (16%). Most of them were mild. One patient expired 34 days after the procedure due to amputation-stump infection, septicaemia, and multiple organ failure. Long-term outcome showed no recurrent bleeding or other embolization-related complications.
  
  
  CONCLUSIONS
  Embolotherapy for the management of hemorrhagic, traumatic vascular injuries in upper and lower limbs is relatively safe, very effective without recurrence or other embolization-related symptoms.
authors.affiliation: Department of Radiology, University Hospitals Leuven, Belgium. geert.maleux@uzleuven.be
authors.forename: Geert
authors.initials: G
authors.lastname: Maleux
authors.forename: Pieter-Jan
authors.initials: PJ
authors.lastname: Herten
authors.forename: Johan
authors.initials: J
authors.lastname: Vaninbroukx
authors.forename: Marleen
authors.initials: M
authors.lastname: Thijs
authors.forename: Stefaan
authors.initials: S
authors.lastname: Nijs
authors.forename: Inge
authors.initials: I
authors.lastname: Fourneau
authors.forename: Sam
authors.initials: S
authors.lastname: Heye
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000628:therapy; D001164:Arteriovenous Fistula / Q000628:therapy; D004621:Embolization, Therapeutic / Q000379:methods*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000628:therapy; D005121:Extremities / Q000098:blood supply*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000628:therapy*; D057772:Vascular System Injuries / Q000628:therapy*; D055815:Young Adult