A modern, multicenter evaluation of hepatic angioembolization - Complications and readmissions persist

Am J Surg. 2020 Jan;219(1):117-122. doi: 10.1016/j.amjsurg.2019.06.021. Epub 2019 Jun 26.

Abstract

Background: Indications for angioembolization (AE) following liver injury are not clearly defined. This study evaluated the outcomes and complications of hepatic AE. We hypothesize hepatic angioembolization is a useful adjunct to non-operative management of liver injury but with significant morbidity.

Methods: Subjects were identified utilizing trauma registries from centers in a regional trauma network from 2010 to 2017 with an Abbreviated Injury Scale (AIS) coded hepatic injury and an ICD9/10 for hepatic angiography (HA).

Results: 1319 patients with liver injuries were identified, with 30 (2.3%) patients undergoing HA: median ISS was 26, and median liver AIS was 4. Twenty-three subjects required AE. 81% had extravasation on CT from a liver injury. 63% underwent HA as initial intervention. 43% of AE subjects had liver-related complications with 35% 30-day readmission but with zero 30-day mortality.

Conclusions: While there were zero reported deaths, a high rate of morbidity and readmission was found. This may be due to the angioembolization or the liver injury itself.

Keywords: Angioembolization; Angiography; Hepatic injuries; Non-operative management.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Angiography
  • Embolization, Therapeutic / adverse effects*
  • Embolization, Therapeutic / methods*
  • Female
  • Hepatic Artery
  • Humans
  • Liver / blood supply
  • Liver / diagnostic imaging
  • Liver / injuries*
  • Male
  • Middle Aged
  • Patient Readmission / statistics & numerical data*
  • Retrospective Studies
  • Treatment Outcome
  • Wounds and Injuries / therapy
  • Young Adult