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Angiography Urged for Vascular Bleeding After Spine Surgery

Rapid progression to angiography after CT can avert serious complications

MONDAY, Aug. 9 (HealthDay News) -- Evaluation of possible vascular injuries occurring during spinal surgery should be rapid, starting with computed tomography (CT) in most cases and progressing immediately to angiography if arterial bleeding is suspected, according to research published in the August issue of the Journal of Spinal Disorders & Techniques.

Hak Sun Kim, Ph.D., of the Yonsei University College of Medicine in Seoul, South Korea, and colleagues conducted a retrospective outcomes study of 10 patients suspected of having a vascular injury after thoracolumbar surgery. The patients were initially evaluated by contrast enhanced CT, and were referred for angiography if major vessel injury and active bleeding was suspected from the CT.

The researchers found that eight of the 10 patients had a vascular injury that was determined to be arterial; three had a venous injury. Angiography was performed in four of the cases of arterial injury, and three of those cases had immediate interventions for active bleeding. Three of the four patients in whom angiography was not performed died during the postoperative period. A total of five of the 10 cases had a significant complication, including death, infection, and cauda equina syndrome.

"The vascular injuries during thoracolumbar spinal surgeries need immediate and aggressive treatment. In arterial injuries, we can prevent serious consequences by subjecting the patient to an angiography as early as possible followed by a therapeutic embolization. In contrast, for venous injuries if hemostasis has been confirmed, then an immediate intervention may not be always required," the authors write.

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