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01-04-2012

Selective Computed Tomography and Angioembolization Provide Benefits in the Management of Patients with Concomitant Unstable Hemodynamics and Negative Sonography Results

Authors: Chih-Yuan Fu, Chi-Hsun Hsieh, Chun-Han Shih, Yu-Chun Wang, Ray-Jade Chen, Hung-Chang Huang, Jui-Chien Huang, Shih-Chi Wu, Hsun-Chung Tsuo, Hsiu-Jung Tung

Published in: World Journal of Surgery | Issue 4/2012

Abstract

Background

The FAST (focused assessment of sonography for trauma) examination can rapidly identify free fluid in the abdominal or thoracic cavity, which is indicative of hemorrhage requiring emergency surgery in multiple-trauma patients. In patients with negative FAST examination results, it is difficult to identify the site of the hemorrhage and to plan treatment accordingly. We attempted to delineate the role of selective computed tomography (CT) and transarterial angioembolization (TAE) in the management of such unstable patients.

Methods

From January 2005 to April 2011 patients with concomitant unstable hemodynamics and negative FAST examination results were identified. Their demographic and time to start of embolization were recorded. The initial systolic blood pressure (SBP) in emergency department patients was compared with the SBP after TAE.

Results

A total of 33 patients were enrolled, and 85% required TAE. SBP improved significantly after TAE. There were 18 patients who received TAE without CT scan because the site of hemorrhage was obvious. Fifteen patients received a CT scan during the time required for angiography preparation. Ten of them received subsequent TAE based on the CT scan findings, and the treatment plan was changed in the other five patients. There was no significant difference between patients with or without a CT scan with respect to the time interval between arrival and starting embolization.

Conclusions

Transarterial angioembolization is suggested in the management of patients with concomitant unstable hemodynamics and negative FAST examination results. During the time interval required for angiography preparation, a CT scan can be performed. This approach provides valuable information for further decision making without delaying definitive treatment.

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Title: Selective Computed Tomography and Angioembolization Provide Benefits in the Management of Patients with Concomitant Unstable Hemodynamics and Negative Sonography Results
Authors: Chih-Yuan Fu
Chi-Hsun Hsieh
Chun-Han Shih
Yu-Chun Wang
Ray-Jade Chen
Hung-Chang Huang
Jui-Chien Huang
Shih-Chi Wu
Hsun-Chung Tsuo
Hsiu-Jung Tung
Publication date: 01-04-2012
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 4/2012
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-012-1457-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Selective Computed Tomography and Angioembolization Provide Benefits in the Management of Patients with Concomitant Unstable Hemodynamics and Negative Sonography Results

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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