Medicine · 2021
Use of N-butyl cyanoacrylate in the successful transcatheter arterial embolization of an arteriovenous fistula caused by blunt pelvic fracture: A case report and review of literature.
Клинический случайСтатьяОбзорНазвание и аннотация: Перевод в очереди
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Cho Hye Soo, Kim Yook, Lee Jisun, Yi Kyung Sik, Choi Chi-Hoon
Аннотация
RATIONALE: Traumatic arteriovenous fistulas (AVFs) of the pelvis are uncommon and present with a variety of clinical manifestations; their detection may be difficult. An endovascular approach is usually the first choice of treatment, because surgical intervention is complicated due to the location of the lesions.
PATIENT CONCERNS: A 68-year-old man was admitted with severe pelvic pain following a fall.
DIAGNOSIS: A pelvic bone fracture (Young and Burgess Classification, lateral compression type II) was revealed on pelvic computed tomography (CT), while a pelvic sidewall hematoma, unaccompanied by any vascular injury, was detected on multidetector CT.
INTERVENTIONS: Pelvic angiography revealed an AVF between the internal iliac artery and vein, which was undetected by MDCT. The AVF was successfully treated using transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate (NBCA).
OUTCOMES: The patient recovered well and was discharged 4 weeks later. No complications were noted at the 8-month follow-up.
LESSONS: AVF may occur as a complication of blunt pelvic bone fracture. A high index of suspicion, angiography, and prompt diagnosis resulted in the successful management of our patient who presented with risk factors. Furthermore, TAE using NBCA enables a minimally invasive and effective treatment of traumatic pelvic AVF.
PATIENT CONCERNS: A 68-year-old man was admitted with severe pelvic pain following a fall.
DIAGNOSIS: A pelvic bone fracture (Young and Burgess Classification, lateral compression type II) was revealed on pelvic computed tomography (CT), while a pelvic sidewall hematoma, unaccompanied by any vascular injury, was detected on multidetector CT.
INTERVENTIONS: Pelvic angiography revealed an AVF between the internal iliac artery and vein, which was undetected by MDCT. The AVF was successfully treated using transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate (NBCA).
OUTCOMES: The patient recovered well and was discharged 4 weeks later. No complications were noted at the 8-month follow-up.
LESSONS: AVF may occur as a complication of blunt pelvic bone fracture. A high index of suspicion, angiography, and prompt diagnosis resulted in the successful management of our patient who presented with risk factors. Furthermore, TAE using NBCA enables a minimally invasive and effective treatment of traumatic pelvic AVF.