Kantonsspital St.Gallen
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Endovascular embolisation is a successful and safe treatment for post-operative arterial complications after total hip arthroplasty and revision surgery

Matthias Erschbamer, Jürgen Den Hollander, Daniel Sauter, Johannes Erhardt, Lukas Hechelhammer & Fabrice Alexander Külling

abstract

PURPOSE
Arterial complications are rare but clinically critical during or following total hip arthroplasty (THA) surgery. They usually require secondary interventions, either through open or endovascular approaches. In a retrospective study, we analysed indications for, as well as success and safety of, endovascular embolisation for arterial complications after THA.

METHODS
We reviewed all arterial complications that had occurred through THA surgery and been treated by endovascular embolisation. We analysed angiographic findings, endovascular treatment, location in relation to the surgical approach and success of the interventions.

RESULTS
Between 1997 and 2013 we performed 3,891 THAs at our hospital. We identified 14 patients with acute arterial complications treated by minimally invasive endovascular embolisation. Clinical findings included swelling of the ipsilateral leg, pain, prolonged wound bleeding, decreased haemoglobin and/or haemodynamic instability. Angiography revealed pseudoaneurysm in 11 patients, arteriovenous fistulas in two and extravasation of contrast media in one. Two patients showed no signs of acute bleeding. Twelve patients were treated, each with a single session of endovascular embolisation; in two additional patients, the haematoma was evacuated. No complications from the endovascular treatment were observed in this series.

CONCLUSION
Endovascular embolisation is a safe and successful minimally-invasive method to treat arterial injuries occurring through THA. Therefore, it should be considered as a first-line option of treatment for those injuries.
   
citation Erschbamer M, den Hollander J, Sauter D, Erhardt J, Hechelhammer L, Külling F A. Endovascular embolisation is a successful and safe treatment for post-operative arterial complications after total hip arthroplasty and revision surgery. Int Orthop 2015; 40:1577-1582.
   
type journal paper/review (English)
date of publishing 28-11-2015
journal title Int Orthop (40/8)
ISSN electronic 1432-5195
pages 1577-1582
PubMed 26614108
DOI 10.1007/s00264-015-3058-2