ABSTRACT
This article outlines general concepts of, and strategies for, therapeutic embolization
throughout the body, touching on all major arterial distributions. Clinical scenarios
that allow or prevent safe embolization of vessels are presented. Specific agents
are recommended where appropriate, as are alternate approaches when embolization is
not an option. Pre-embolization precautions and adjunctive measures are described
in high-risk areas.
KEYWORDS
Embolization - trauma - angiography
REFERENCES
1
Mavroudis C, Backer C L, Rocchini A P, Muster A J, Gevitz M.
Coronary artery fistulas in infants and children: a surgical review and discussion
of coil embolization.
Ann Thorac Surg.
1997;
63(5)
1235-1242
2
Chambers C M, Curci J A.
Treatment of nonaortic aneurysms in the endograft era: aneurysms of the innominate
and subclavian arteries.
Semin Vasc Surg.
2005;
18(4)
184-190
3
Hirose H, Gill I S.
Blunt injury of the innominate artery: a case report and review of literature.
Ann Thorac Cardiovasc Surg.
2004;
10(4)
218-223
4
Johnston R H, Wall M J, Mattox K L.
Innominate artery trauma: a thirty-year experience.
J Vasc Surg.
1993;
17(1)
134-139
5
Scalea T M, Sclafani S J.
Angiographically placed balloons for arterial control: a description of a technique.
J Trauma.
1991;
31(12)
1671-1677
6
Marvasti M A, Parker Jr F B, Bredenberg C E.
Injuries to arterial branches of the aortic arch.
Thorac Cardiovasc Surg.
1984;
32(5)
293-298
7
Whitley D, Cherry Jr K J.
Predictive value of carotid artery stump pressures during carotid endarterectomy.
Neuro Clin N Am.
1996;
7(4)
723-732
8
McIntosh D L, Douglas G, Lee K, Allen J, Mahadevan M.
External carotid artery blood supply to the orbit.
Int J Pediatr Otorhinolaryngol.
2007;
71(10)
1623-1626
9
du Toit D F, Leith J G, Strauss D C et al..
Endovascular management of traumatic cervicothoracic arteriovenous fistula.
Br J Surg.
2003;
90(12)
1516-1521
10
Mwipatayi B P, Jeffery P, Beningfield S J et al..
Management of extra-cranial vertebral artery injuries.
Eur J Vasc Endovasc Surg.
2004;
27(2)
157-162
11
Riesenman P J, Farber M A, Mendes R R et al..
Coverage of the left subclavian artery during thoracic endovascular aortic repair.
J Vasc Surg.
2007;
45(1)
90-94
discussion 94-95
12
Tehrani H Y, Peterson B G, Katariya K et al..
Endovascular repair of thoracic aortic tears.
Ann Thorac Surg.
2006;
82(3)
873-877
discussion 877-878
13
Orend K H, Zarbis N, Schelzig H et al..
Endovascular treatment (EVT) of acute traumatic lesions of the descending thoracic
aorta–7 years' experience.
Eur J Vasc Endovasc Surg.
2007;
34(6)
666-672
14
Aggarwal S, Willinsky R, Montanera W, Terbrugge K, Wallace M C.
Superselective angiography of a spinal dural arteriovenous fistula having a common
segmental origin with the artery of Adamkiewicz.
Neuroradiology.
1992;
34(4)
352-354
15
Tanaka N, Yamakado K, Murashima S et al..
Superselective bronchial artery embolization for hemoptysis with a coaxial microcatheter
system.
J Vasc Interv Radiol.
1997;
8(1 Pt 1)
65-70
16
White Jr R I.
Bronchial artery embolotherapy for control of acute hemoptysis: analysis of outcome.
Chest.
1999;
115(4)
912-915
17
Uflacker R, Kaemmerer A, Neves C, Picon P D.
Management of massive hemoptysis by bronchial artery embolization.
Radiology.
1983;
146(3)
627-634
18
Pump K K.
Distribution of bronchial arteries in the human lung.
Chest.
1972;
62(4)
447-451
19
Chapman S A, Holmes M D, Taylor D J.
Unilateral diaphragmatic paralysis following bronchial artery embolization for hemoptysis.
Chest.
2000;
118(1)
269-270
20
White Jr R I, Pollak J S, Wirth J A.
Pulmonary arteriovenous malformations: diagnosis and transcatheter embolotherapy.
J Vasc Interv Radiol.
1996;
7(6)
787-804
21
Gwon D I, Ko G Y, Yoon H K et al..
Inferior phrenic artery: anatomy, variations, pathologic conditions, and interventional
management.
Radiographics.
2007;
27(3)
687-705
22
Shin S W, Do Y S, Choo S W et al..
Diaphragmatic weakness after transcatheter arterial chemoembolization of inferior
phrenic artery for treatment of hepatocellular carcinoma.
Radiology.
2006;
241(2)
581-588
23
Syed M, Shaikh A, Neravetla S.
Celiac artery aneurysm embolization by coil occlusion.
Ann Vasc Surg.
2005;
19(1)
113-119
24
Vaddineni S K, Taylor S M, Patterson M A, Jordan Jr W D.
Outcome after celiac artery coverage during endovascular thoracic aortic aneurysm
repair: preliminary results.
J Vasc Surg.
2007;
45(3)
467-471
25
Saito N, Kimura T, Toma M et al..
Endovascular repair of a thoracoabdominal aortic aneurysm involving the celiac artery
and the superior mesenteric artery.
Ann Vasc Surg.
2006;
20(5)
659-663
26
Sato K, Lewandowski R J, Bui J T et al..
Treatment of unresectable primary and metastatic liver cancer with yttrium-90 microspheres
(TheraSphere): assessment of hepatic arterial embolization.
Cardiovasc Intervent Radiol.
2006;
29(4)
522-529
27
Covey A M, Brody L A, Maluccio M A, Getrajdman G I, Brown K T.
Variant hepatic arterial anatomy revisited: digital subtraction angiography performed
in 600 patients.
Radiology.
2002;
224(2)
542-547
28
Haan J M, Biffl W, Knudson M M et al..
Splenic embolization revisited: a multicenter review.
J Trauma.
2004;
56(3)
542-547
29
Sclafani S J, Shaftan G W, Scalea T M et al..
Nonoperative salvage of computed tomography-diagnosed splenic injuries: utilization
of angiography for triage and embolization for hemostasis.
J Trauma.
1995;
39(5)
818-825
discussion 826-817
30
Schwalke M A, Crowley J P, Spencer P et al..
Splenic artery ligation for splenic salvage: clinical experience and immune function.
J Trauma.
1991;
31(3)
385-388
31
Koconis K G, Singh H, Soares G.
Partial splenic embolization in the treatment of patients with portal hypertension:
a review of the English language literature.
J Vasc Interv Radiol.
2007;
18(4)
463-481
32
Mozes M F, Spigos D G, Pollak R et al..
Partial splenic embolization, an alternative to splenectomy–results of a prospective,
randomized study.
Surgery.
1984;
96(4)
694-702
33
Shah R, Mahour G H, Ford E G, Stanley P.
Partial splenic embolization. An effective alternative to splenectomy for hypersplenism.
Am Surg.
1990;
56(12)
774-777
34
Yoshioka H, Kuroda C, Hori S et al..
Splenic embolization for hypersplenism using steel coils.
AJR Am J Roentgenol.
1985;
144(6)
1269-1274
35
Yoshida H, Mamada Y, Taniai N, Tajiri T.
Partial splenic embolization.
Hepatol Res.
2008;
38(3)
225-233
36
Park J H, Kang K P, Lee S J et al..
A case of a ruptured pheochromocytoma with an intratumoral aneurysm managed by coil
embolization.
Endocr J.
2003;
50(6)
653-656
37
Kawashima A, Sandler C M, Ernst R D et al..
Imaging of nontraumatic hemorrhage of the adrenal gland.
Radiographics.
1999;
19(4)
949-963
38
Gonzalez Valverde F M, Balsalobre M, Torregrosa N et al..
Spontaneous retroperitoneal hemorrhage from adrenal artery aneurysm.
Cardiovasc Intervent Radiol.
2007;
30(2)
307-309
39
Baccot S, Tiffet O, Bonnot P, Perrot L, Cuilleret J.
Bilateral post-traumatic adrenal hemorrhage. Report of a case with acute adrenal insufficiency.
Ann Chir.
2000;
125(3)
273-275
40
Guichelaar M M, Leenen L P, Braams R.
Transient adrenocortical insufficiency following traumatic bilateral adrenal hemorrhage.
J Trauma.
2004;
56(5)
1135-1137
41
Igwilo O C, Sulkowski R J, Shah M R, Messink W F, Kinnas N C.
Embolization of traumatic adrenal hemorrhage.
J Trauma.
1999;
47(6)
1153-1155
42
Abbara S, Nikolic B, Pelage J P, Banovac F, Spies J B.
Frequency and extent of uterine perfusion via ovarian arteries observed during uterine
artery embolization for leiomyomas.
AJR Am J Roentgenol.
2007;
188(6)
1558-1563
43
Brotman S, Soderstrom C A, Oster-Granite M et al..
Management of severe bleeding in fractures of the pelvis.
Surg Gynecol Obstet.
1981;
153(6)
823-826
44
Yasumura K, Ikegami K, Kamohara T, Nohara Y.
High incidence of ischemic necrosis of the gluteal muscle after transcatheter angiographic
embolization for severe pelvic fracture.
J Trauma.
2005;
58(5)
985-990
45
Suzuki T, Shindo M, Kataoka Y et al..
Clinical characteristics of pelvic fracture patients with gluteal necrosis resulting
from transcatheter arterial embolization.
Arch Orthop Trauma Surg.
2005;
125(7)
448-452
46
Gourlay D, Hoffer E, Routt M, Bulger E.
Pelvic angiography for recurrent traumatic pelvic arterial hemorrhage.
J Trauma.
2005;
59(5)
1168-1173
discussion 1173-1164
47
Ramirez J I, Velmahos G C, Best C R, Chan L S, Demetriades D.
Male sexual function after bilateral internal iliac artery embolization for pelvic
fracture.
J Trauma.
2004;
56(4)
734-739
discussion 739-741
48
Henriet J P.
Sapheno-femoral venous confluence and the external pudendal network: anatomical data
and new statistics.
Phlebologie.
1987;
40(3)
711-735
Thomas R BurdickM.D.
Assistant Professor, Radiology, University of Washington, Director of Interventional
Radiology, Harborview Medical Center
Department of Radiology Box 359728, 325 9th Avenue Seattle, WA 98104
eMail: vasculopath@gmail.com