J Korean Soc Radiol.  2021 Jul;82(4):923-935. 10.3348/jksr.2020.0116.

Traumatic Hemothorax Caused by Thoracic Wall and Intrathoracic Injuries: Clinical Outcomes of Transcatheter Systemic Artery Embolization

• Lee CM
• Jeon CH
• Lee R
• Kwon H
• Kim CW
• Kim JH
• Kim JH
• Kim H
• Kim SH
• Lee CK
• Park CY
• Bae M

• KMID: 2518622
• DOI: http://doi.org/10.3348/jksr.2020.0116

Abstract

Purpose
We aimed to assess the clinical efficacy of transcatheter arterial embolization (TAE) for treating hemothorax caused by chest trauma.
Materials and Methods
Between 2015 and 2019, 68 patients (56 male; mean age, 58.2 years) were transferred to our interventional unit for selective TAE to treat thoracic bleeding. We retrospectively investigated their demographics, angiographic findings, embolization techniques, technical and clinical success rates, and complications.
Results
Bleeding occurred mostly from the intercostal arteries (50%) and the internal mammary arteries (29.5%). Except one patient, TAE achieved technical success, defined as the immediate cessation of bleeding, in all the other patients. Four patients successfully underwent repeated TAE for delayed bleeding or increasing hematoma after the initial TAE. The clinical success rate, defined as no need for thoracotomy for hemostasis after TAE, was 92.6%. Five patients underwent post-embolization thoracotomy for hemostasis. No patient developed major TAE-related complications, such as cerebral infarction or quadriplegia.
Conclusion
TAE is a safe, effective and minimally invasive method for controlling thoracic wall and intrathoracic systemic arterial hemorrhage after thoracic trauma. TAE may be considered for patients with hemothorax without other concomitant injuries which require emergency sur-gery, or those who undergoing emergency TAE for abdominal or pelvic hemostasis.

Keyword

Embolotherapy; Hemothorax; Interventional Radiology; Thoracic Injuries; Thoracotomy