Abstract No. 667 Transcatheter arterial embolization for traumatic thoracic bleeding: 4-year experiences in a single trauma center

Abstract

We aimed to assess the safety and efficacy of transcatheter arterial embolization (TAE) for thoracic arterial hemorrhage following chest trauma. From November 2013 to May 2017, 35 patients were referred to our interventional unit for thoracic arterial bleeding following chest trauma, based on clinical decisions and computed tomography (CT) images. A total of 35 patients (male:female ratio, 26:9; mean age, 52.9 years) who underwent selective TAE of thoracic hemorrhage-culprit arteries were included in this study. Technical and clinical success, complications, and 30-day mortality rate were analyzed. In 35 patients who underwent TAE, the main bleeding arteries were intercostal artery (n=23), internal mammary artery (n=11) superior and/or lateral thoracic artery (n=3), and bronchial artery (n=3). N-butyl-2-cyanoacrylate (NBCA) (n=21), gelatin sponge particles (n=7), microcoils (n=2), and combinations of NBCA, microcoils, or gelatin sponge particles (n=10) were used as embolic agents. Initial technical success was achieved in all 27 patients, with immediate cessation of bleeding. Eight patients showed rebleeding 1-2 days later and underwent repeated TAE with successful result. Clinical success rate was 85.7% (30/35), and five patients underwent thoracotomy for controlling residual bleed. There were no TAE-related major complications such as infarction or quadriplegia. The 30-day mortality rate was 5.7% (2/35). Our clinical experience suggests that TAE used to control thoracic arterial bleeding following chest trauma is safe and effective as a minimally invasive treatment alternative to surgery.