Open AccessUse of N-butyl cyanoacrylate in the successful transcatheter arterial embolization of an arteriovenous fistula caused by blunt pelvic fracture
Author(s) -
Hye Soo Cho,
Yook Kim,
Jisun Lee,
Kyung Sik Yi,
Chi Hoon Choi
Publication year - 2021
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000024215
Subject(s) - medicine , embolization , pelvic fracture , pelvis , radiology , surgery , arteriovenous fistula , angiography , blunt trauma , blunt , internal iliac artery , hematoma , cyanoacrylate , arterial embolization , complication , chemistry , adhesive , organic chemistry , layer (electronics)
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.