2016 Volume 31 Issue 4 Pages 356-359
Total hip arthroplasty (THA) is one of the most frequently performed orthopedic surgeries. Although THA is relatively safe, a complication that sometimes occurs is severe bleeding. Transcatheter arterial embolization (TAE) is the first-choice treatment for bleeding, but surgery is also sometimes used. A woman in her 80s was admitted to our hospital, and THA with the direct anterior approach was performed. After the operation, severe bleeding from a drain persisted. Extravasation was found around the operation wound on enhanced computed tomography, and so emergency TAE was performed. Angiography revealed extravasation from a branch of the profunda femoris artery. Because coagulopathy was present, we selected N-butyl cyanoacrylate (NBCA) as the embolus material. There were no complications associated with TAE for this patient. For TAE performed for bleeding after THA, a gelatin sponge or micro-coil is often selected as the embolus material. As in cases of severe trauma, it is important to select NBCA as the embolus material for postoperative bleeding after THA, taking into consideration the patient’s coagulation status.
