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Volume 49, Issue 6 , Pages 1505-1513 , June 2009

Transcatheter arterial embolization for the management of iatrogenic and blunt traumatic intercostal artery injuries

Andreas P. Chemelli, MD
- Department of Radiology, Innsbruck Medical University, Innsbruck, Austria
Michael Thauerer, MD
- Department of General and Transplant Surgery, Innsbruck Medical University, Innsbruck, Austria
Franz Wiedermann, MD
- Department of Anaesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria
Alexander Strasak, PhD
- Department of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Innsbruck, Austria
Josef Klocker, MD
- Department of Vascular Surgery, Innsbruck Medical University, Innsbruck, Austria
Iris E. Chemelli-Steingruber, MD
- Department of Radiology, Innsbruck Medical University, Innsbruck, Austria
- Reprint requests: Iris Chemelli-Steingruber, MD, Department of Radiology, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria

Received 9 December 2008 ,Accepted 1 February 2009.

A 57-year-old patient (patient 3). a, Contrast enhanced computed tomography (CT) of the thorax reveals a fracture of the second to the tenth left ribs and a pseudoaneurysm within the chest wall, origi

A 57-year-old patient (patient 3). a, Contrast enhanced computed tomography (CT) of the thorax reveals a fracture of the second to the tenth left ribs and a pseudoaneurysm within the chest wall, originating from the injured tenth intercostal artery (ICA). b, The same CT study shows a contrast extravasation into the pleural cavity in addition to the pseudoaneurysm seen above.
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A 71-year-old patient (patient 20). a, Chest x-ray shows left-sided hemothorax after puncture of a pleural effusion. b, Selective angiography of the ninth intercostal artery (ICA) demonstrates a pseud

A 71-year-old patient (patient 20). a, Chest x-ray shows left-sided hemothorax after puncture of a pleural effusion. b, Selective angiography of the ninth intercostal artery (ICA) demonstrates a pseudoaneurysm of a small side branch of the ICA. c, Selective angiography shows successful closure of the bleeding source by means of microcoils and PVA particles. d, Chest x-ray after endovascular intervention and insertion of chest tubes shows disappearance of pleural effusion and hemothorax.
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Kaplan-Meier estimates of cumulative survival in group A (blunt traumatic injuries) and group B (iatrogenic injuries).

Kaplan-Meier estimates of cumulative survival in group A (blunt traumatic injuries) and group B (iatrogenic injuries).
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A 58-year-old patient (patient 6). a, Selective angiography demonstrates a pseudoaneurysm, which arises from the ninth intercostal artery (ICA). b, Selective angiography shows that the pseudoaneurysm

A 58-year-old patient (patient 6). a, Selective angiography demonstrates a pseudoaneurysm, which arises from the ninth intercostal artery (ICA). b, Selective angiography shows that the pseudoaneurysm is also fed by the musculophrenic artery (via the internal mammary artery). c, Selective angiography reveals a third route of blood supply to the pseudoaneurysm via the inferior phrenic artery.
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