Which Arteries Are Expendable? The Practice and Pitfalls of Embolization throughout the Body

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