Transcatheter hepatic arterial embolization for the treatment of blunt hepatic injury

To examine the indications of transcatheter arterial embolization (TAE) for blunt hepatic injury, angiographic images, CT images and medical records were reviewed. Hepatic angiography was performed in 30 patients with blunt hepatic injury. Sixteen of them who underwent TAE therapy immediately after angiography formed the TAE(+)group, while the 14 patients who were not followed by TAE formed the TAE(-)group. Angiographic extravasation of the contrast medium was confirmed in 14 of 16 patients in the TAE(+)group. On CT scan, the most common finding in the TAE(+)group was a deep hepatic laceration, which was classified as type III according to the criteria of the Japanese association for the surgery of trauma. Hemoperitoneum and fresh hematoma were visualized in most of the TAE(+)group. The preoperative hemodynamics of the TAE(+)group were markedly unstable, but were significantly improved after TAE therapy. No major complications were encountered during or after TAE. These results suggested that TAE was an effective therapeutic procedure for the control of blunt hepatic injury in patients associated with unstable hemodynamics, deep hepatic laceration shown by CT scan and extravasation confirmed by angiography.