1. Feasibility of intraoperative angioembolization for trauma patients using C-arm digital subtraction angiography
- Author
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Abdulaziz, Alnumay, Natasha, Caminsky, Jules Hugo, Eustache, David, Valenti, Andrew Neil, Beckett, Dan, Deckelbaum, Paola, Fata, Kosar, Khwaja, Tarek, Razek, Katherine Marlene, McKendy, Evan Gordon, Wong, and Jeremy Richard, Grushka
- Subjects
Male ,Trauma Centers ,Angiography, Digital Subtraction ,Feasibility Studies ,Humans ,Female ,Wounds, Nonpenetrating ,Embolization, Therapeutic ,Retrospective Studies - Abstract
Hemodynamically unstable trauma patients who would benefit from angioembolization (AE) typically also require emergent surgery for their injuries. The critical decision of transferring a patient to the operating room versus the interventional radiology (IR) suite can be bypassed with the advent of intra-operative AE (IOAE). Previously limited by the availability of costly rooms termed RAPTOR (resuscitation with angiography, percutaneous techniques and open repair) suites, it has been suggested that using C-arm digital subtraction angiography (DSA) is a comparable alternative. This case series aims to establish the feasibility and safety of IOAE.We conducted a retrospective analysis of all trauma patients at our level 1 trauma center who underwent IOAE with a concomitant surgical intervention from January 2011 to May 2019. Descriptive analyses were conducted.A total of 49 patients (80% male, 44 ± 17 years, 92% blunt) underwent IOAE using the C-arm DSA during the study period. All but one patient underwent exploratory laparotomy, 56% of which underwent an additional surgical procedure (ex. exploratory thoracotomy, orthopedic). Either GelfoamIOAE appears to be a feasible and safe management option in severe trauma patients with the advantage of concurrent operative intervention and ongoing active resuscitation with good success in hemorrhage control.
- Published
- 2020