title: Retrospective 12-year study of the safety and efficacy of transcatheter arterial embolization for managing bleeding complications following hip surgery.
abstract: OBJECTIVE
  This study was designed to evaluate the safety and effectiveness of transcatheter arterial embolization (TAE) for stopping bleeding following hip surgery.
  
  
  METHODS
  We performed a 12-year retrospective analysis of 13 patients (M:F = 6:7, median age 72 years) who underwent angiography for bleeding following hip surgery. The types of surgery, latency time, angiographic findings, TAE details, procedure-related complications, and clinical outcomes were analyzed. Technical success was defined as no further bleeding detected on angiography following embolization.
  
  
  RESULTS
  Total hip replacement arthroplasty was the most common surgery performed for these patients (n = 10). Seven of the 13 study patients underwent angiography the same day as their surgery. Angiograms showed active (n = 11) or suspicious (n = 1) bleeding in 12 of the 13 patients. Gelatin sponge particles, coils, NBCA, PVA, and their combinations were used as the embolic material. For the one patient without obvious signs of bleeding, prophylactic TAE was done to achieve bleeding control. For the 11 patients with active bleeding, 10 underwent technically successful TAE, and 1 patient underwent surgery due to a large pseudoaneurysm located near the bifurcation of the common femoral artery. There were no major procedure-related complications or patient mortality. The 30-day mortality rate was 15% (2/13), and both of these patients died of multiorgan failure.
  
  
  CONCLUSIONS
  Transcatheter angiography is useful for identifying bleeding arteries. TAE is safe and effective for managing bleeding after hip surgery.
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Hongtao
authors.initials: H
authors.lastname: Cheng
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Shin
authors.forename: Hyun Ki
authors.initials: HK
authors.lastname: Yoon
authors.forename: Jooae
authors.initials: J
authors.lastname: Choe
authors.forename: Gi Young
authors.initials: GY
authors.lastname: Ko
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Gwon
authors.forename: Heung Kyu
authors.initials: HK
authors.lastname: Ko
authors.forename: Jin Hyoung
authors.initials: JH
authors.lastname: Kim
authors.forename: Kyu Bo
authors.initials: KB
authors.lastname: Sung
mesh_terms: D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D019644:Arthroplasty, Replacement, Hip; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D019106:Postoperative Hemorrhage / Q000000981:diagnostic imaging / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome