Massimo Venturini MD, Presenter: Nothing to Disclose

Francesco Aldo De Cobelli MD, Abstract Co-Author: Nothing to Disclose

Marco Salvioni, Abstract Co-Author: Nothing to Disclose

Stefano Cappio MD, Abstract Co-Author: Nothing to Disclose

Giulia Agostini, Abstract Co-Author: Nothing to Disclose

Corrado Soldati, Abstract Co-Author: Nothing to Disclose

Michaela Cellina, Abstract Co-Author: Nothing to Disclose

Antonio Esposito MD, Abstract Co-Author: Nothing to Disclose

Alessandro Del Maschio MD, Abstract Co-Author: Nothing to Disclose

Our aim was to evaluate the effectiveness of PTE in the treatment of iatrogenic vascular lesions of peripheral branches of profunda femoris artery (and hypogastric artery) due to femoral reconstructive surgery.

From 1989 to 2011, we treated 36 patients (mean age 66.9) with expanding hematoma and increasing anemization due to an acute arterial bleeding following to femoral surgical treatments (21 cases of fragmentary fractures; 15 cases of arthroplastic procedures, 14 due to arthrosis and one due to congenital dislocation of the hip). A selective PTE was performed using a controlateral femoral approach and after angiographic demonstration of bleeding arterial lesions (lacerations, pseudoaneurysms, arteriovenous fistulas) of distal branches of profunda femoris artery and hypogastric artery. A 4-F catheter was used in 24 cases, a microcatheter in 12 cases. Different embolization materials were used: Gianturco microcoils, PVA particles, embo-sphere. Follow-up was based on clinical controls and color-Doppler US. Angiography was repeated in case of further clinical signs of bleeding/anemization.

A selective occlusion of the bleeding arteries with consequent hemodynamic stabilization was obtained in a single procedure in 34 of 36 patients (94.4%). Two of 36 patients, complicated by DIC and hemorrhagic shock, were resubmitted to angiography and PTE: hemodynamic stabilization was obtained in one patient after 3 PTE (3 times in a week), in another patient, unsuccessfully submitted to 2 PTE, after surgical occluding ligature at the origin of profunda femoris artery.

Selective PTE of profunda femoris artery, particularly of its distal branches generally difficult to be repaired by surgery, is an effective treatment in case of bleeding vascular iatrogenic or traumatic lesions. An early treatment immediately after the first signs of anemization can simultaneously reduce the risk of death and DIC.

In case of anemization due to arterial lesions of profunda femoris artery after femoral reconstructive surgery, PTE represents the first choice treatment.

Venturini, M, De Cobelli, F, Salvioni, M, Cappio, S, Agostini, G, Soldati, C, Cellina, M, Esposito, A, Del Maschio, A, Percutaneous Transcatheter Embolization (PTE) of the Profunda Femoris Artery for Latrogenic Lesions Due to Orthopaedic Reconstructive Surgery.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11006465.html