What happens if the left or right gastric artery is embolized during hepatic chemoembolization? Injecting chemotherapeutic agents directly into the bowel can cause irreversible gastric ischemia and eventual necrosis. Meticulous attention to possible variants in gastric/bowel vascular supply is necessary when performing preembolization diagnostic arteriograms.
Why is it necessary to embolize both sides of a pseudoaneurysm aneurysm or AVF? Significant reconstitution of flow via collaterals can occur and cause recurrence of the lesion. If only the proximal feeding vessel to a pseudoaneurysm is embolized, flow may reverse in the outflow vessel and feed the pseudoaneurysm. Embolizing both sides of a …
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Why should coils not be used in the bronchial arteries? Life-threatening hemoptysis is often caused by chronic lung disease, such as sarcoidosis or cystic fibrosis. Because of the chronic nature of the lung disease, hemoptysis is likely to recur. Embolization with coils makes future access to the embolized vascular territory difficult, if not impossible. Particulate …
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Is empiric embolization indicated in pelvic trauma? In the setting of a pelvic fracture, bleeding may be from numerous sources. Venous bleeding is the most common etiology. Bleeding from the periosteal surface of fractured bones is the next most common etiology, followed by arterial hemorrhage. In the setting of an arteriogram with normal results, arterial …
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Vigilance for which vessels is imperative in bronchial artery embolization for hemoptysis? Anterior spinal arteries arising from bronchial arteries must be identified to prevent nontarget embolization and subsequent paraplegia. Anterior spinal artery branches that arise from bronchial arteries have a classic “hairpin” appearance, traveling cranially for 1 cm or so before forming a loop and doubling …
Clinical indications for arteriography in pelvic trauma The pelvis represents a very large potential space, often able to accommodate 4 to 5 L of blood. Traumatic diastasis of the symphysis pubis can double the effective potential space of the pelvis. Pelvic bleeding can be difficult to control surgically. Splinting and external fixation are usually performed first …
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In the setting of pelvic trauma or peripartum hemorrhage in a patient with an unstable condition, is superselective embolization always indicated? In emergent settings, with a patient with an unstable condition, the goal is efficient hemostasis and stabilization of the patient’s condition. Embolization of the entire internal iliac artery, if necessary, can be performed, usually …