Predicting post-therapy response to radioembolization using computational image analysis in patients with hepatocellular carcinoma

Abstract

Transcatheter arterial embolization (TAE) is commonly used to control hemorrhage after pelvic trauma. Despite the procedure's reported safety, there can be severe complications, mostly related to ischemia of embolized tissues. Our purpose was to examine the complications of trauma patients resulting from the embolization techniques utilized at our level 1 trauma center. Materials: A retrospective chart review was conducted. 107 patients who underwent pelvic embolization between January 2003 and December 2013 were included. Patient demographics, ISS, angiography techniques, and major complications including gluteal and skin necrosis, wound breakdown, and deep infection were compared. Results: 9 patients (8.4%) developed major complications after undergoing TAE. This rate dropped to 5.1% after exclusion of patients with Morel-Lavallee lesions. Nonselective embolization trended towards a higher complication rate compared to superselective embolization. Patients who developed complications were more likely to have undergone pelvic surgery. Conclusions: The majority of patients who developed complications had nonselective TAE. Morel-Lavallee lesions are a confounding factor, but TAE likely imposes an additional risk. Pelvic surgery after TAE may further predispose patients to complications. We recommend superselective embolization as first line treatment and caution the use of prophylactic embolization, especially in patients with significant pelvic soft tissue injuries.