Emergency percutaneous transcatheter embolisation of acute arterial haemorrhage

Abstract

Aims: The purpose of this study was to review indications, source of haemorrhage, method of embolisation and clinical outcome in patients referred to Interventional Radiology for the emergency management of acute arterial haemorrhage.

Methods: Retrospective review of patients undergoing emergency percutaneous embolisation over 4 years. Clinical details, computed tomographic findings, embolisation procedure details and clinical outcome are outlined.

Results: Patients (n = 41) were included with various clinical indications for embolisation [haemoptysis (n = 8), iatrogenic (n = 7), traumatic pseudoaneurysm (n = 3), retroperitoneal bleed (n = 3), GI bleed (n = 6), splenic rupture (n = 1), renal laceration (n = 1), epistaxis (n = 12)]. Embolisation material consisted of coils, embospheres, glue, and covered stents. Technical success was achieved in 100% of cases. One patient died 2 days after embolisation secondary to myocardial infarction.

Conclusion: Emergency arterial embolisation is a potentially life-saving treatment. Although it is technically challenging, indications are becoming increasingly varied and outcomes are more successful because of the availability of microcatheters and effective embolisation materials.