Giuseppe Rossi MD, Abstract Co-Author: Nothing to Disclose

Andreas F. Mavrogenis, Abstract Co-Author: Nothing to Disclose

Eugenio Rimondi MD, Presenter: Nothing to Disclose

Daniel Vanel MD, Abstract Co-Author: Nothing to Disclose

Pietro Ruggieri, Abstract Co-Author: Nothing to Disclose

Mario Mercuri MD, Abstract Co-Author: Nothing to Disclose

To present the largest series reporting on selective embolization for vascular injuries complicating elective orthopaedic operations, and to discuss the indications.

We retrospectively studied the medical files of 31 patients with vascular injuries complicating elective orthopaedic operations from 2003 to 2010. There were 21 men and 10 women with a mean age of 48 years (range, 18 to 88 years). All patients underwent diagnostic angiography and selective or superselective transcatheter embolization; none of these patients had a vascular surgical intervention as first-line or definite treatment. The mean follow-up was 37 months (range, 4 to 96 months).

The most common orthopaedic operations associated with vascular injuries were hip joint procedures (23/31 operations), followed by knee joint procedures, tumor surgery and spine surgery. The most common vascular injuries were arterial tears (22/32 vascular complications) followed by pseudoaneurysm and arteriovenous fistula formation. The most commonly injured artery was the superior gluteal artery (11/32 vascular complications) followed by the theprofunda femoral artery, the genicular arteries, the lateral circumflex femoral artery, the iliolumbar artery, the inferior gluteal artery, the medial circumflex femoral artery, and the inferior epigastric artery. In all cases, angiography showed the bleeding point. All patients had a single embolization session; in all patients, bleeding was effectively controlled and hemodynamic status recovered. Complications related to the embolization procedure or the vascular injury were not observed.

Embolization for vascular complications in elective orthopaedic surgery is highly effective, successful, and safe. It should be considered as the first option in the treatment of these injuries because of the advantages of minimally invasive therapy and the lack of complications.

The incidence of vascular complications after elective orthopaedic surgery ranges from 0.005% to 0.5%.Embolization of bleeding vessels has both a diagnostic and therapeutic role.

Rossi, G, Mavrogenis, A, Rimondi, E, Vanel, D, Ruggieri, P, Mercuri, M, Embolization for Vascular Injuries Complicating Elective Orthopaedic Surgery.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11004771.html