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Embolization for pediatric trauma.

Eric D Cyphers1, Michael R Acord2,3, Marian Gaballah4

  • 1Division of Interventional Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, USA. cypherse@chop.edu.

Pediatric Radiology
|November 14, 2023
PubMed
Summary
This summary is machine-generated.

Arterial embolization is a feasible treatment for pediatric trauma hemorrhage control, achieving 100% technical success but a 20% clinical failure rate. Further standardization may improve outcomes in managing pediatric trauma patients.

Keywords:
EmbolizationInterventionalPediatricTrauma

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Area of Science:

  • Interventional Radiology
  • Pediatric Trauma Surgery
  • Vascular Surgery

Background:

  • Pediatric trauma management with trans-arterial embolization is infrequently documented compared to adult cases.
  • Limited literature exists on the efficacy and safety of arterial embolization in pediatric trauma patients.

Purpose of the Study:

  • To evaluate the single-center experience of a level 1 trauma center in utilizing arterial embolization for pediatric trauma.
  • To analyze outcomes, including technical and clinical success rates, adverse events, and transfusion requirements.

Main Methods:

  • Retrospective review of 20 pediatric trauma patients (4.5 months to 17 years) undergoing arterial embolization over 19 years.
  • Data collected included demographics, transfusion needs, imaging, procedural details, and outcomes.
  • Technical success defined as angiographic resolution or empiric embolization; clinical success defined as no further intervention.

Main Results:

  • 100% technical success (20/20) and 80% clinical success (16/20) were achieved.
  • 15/20 patients required transfusions (mean 64 ml/kg).
  • 20% (4/20) experienced continued bleeding, with 15% mortality (3/20) and one severe adverse event (iliac artery pseudoaneurysm).

Conclusions:

  • Arterial embolization is a feasible, though challenging, option for hemorrhage control in pediatric trauma.
  • A 20% clinical failure rate highlights the complexity and need for improved standardization.
  • Standardizing pre-embolization assessment and techniques may enhance outcomes in pediatric trauma embolization.