Selective transarterial embolization for XXXX : a second try is worthwhile.

@entity1 @entity130 @entity548
PURPOSE: Selective percutaneous transarterial embolization has proved to be effective, safe treatment for @entity548 but inefficacious procedures often lead to nephrectomy. Thus, the success rate of transarterial embolization should be maximized. MATERIAL AND METHODS: We retrospectively investigated the clinical success rate of transarterial embolization for posttraumatic @entity548 . Study inclusion criteria were imaging evidence and clinical signs of @entity548 or a hemoglobin decrease of more than 2 gm/dl in urological cases. We excluded spontaneous @entity548 from analysis. RESULTS: A total of 21 @entity1 with a median age of 66 years (range 12 to 78) met study inclusion criteria. Etiology was blunt @entity130 in 3 cases (14%), stab wound in 1 (5%) and an iatrogenic cause in 17 (81%). In 2 @entity1 an active @entity548 site could not be detected during selective angiography. Transarterial embolization was done in 19 @entity1 and led to primary clinical success in 12 (63%), including 2 with grade V parenchymal injury. In 6 of 7 cases (86%) in which primary treatment failed transarterial embolization was repeated. It resulted in clinical success in 4 of 6 @entity1 (67%) with equal efficiency (p =1). Three @entity1 (16%) who could not be sufficiently treated with transarterial embolization underwent nephrectomy. CONCLUSIONS: When conservative measures fail and clinical symptoms or a relevant hemoglobin decrease occur, transarterial embolization should be considered. Since the success rate is equally high for initial and repeat interventions, re-intervention is justified when the clinical course allows.
