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Role and Effectiveness of Percutaneous Arterial Embolization in Hemodynamically Unstable Patients with Ruptured Splanchnic Artery Pseudoaneurysms.
- Source :
-
Cardiovascular and interventional radiology [Cardiovasc Intervent Radiol] 2015 Aug; Vol. 38 (4), pp. 862-70. Date of Electronic Publication: 2014 Oct 24. - Publication Year :
- 2015
-
Abstract
- Purpose: To assess the role and effectiveness of percutaneous arterial embolization (TAE) in patients with hemodynamic instability due to hypovolemic shock secondary to ruptured splanchnic artery pseudoaneurysms (SAPA).<br />Materials and Methods: Seventeen patients (11 men, 6 women; mean age, 53 years) with hemodynamic instability (systolic blood pressure <90 mmHg) due to hypovolemic shock secondary to ruptured SAPA were treated by TAE. Clinical files, multidetector row computed tomography angiography, and angiographic examinations along with procedure details were reviewed.<br />Results: Seventeen SAPAs were present, predominantly located on gastroduodenal or pancreatic arteries (9/17; 53%). Angiography showed extravasation of contrast medium from SAPA in 15/17 patients (88%). Technical success rate of TAE was 100%. TAE was performed using metallic coils in all patients (100%), in association with gelatin sponge in 5/17 patients (29%). TAE allowed controlling the bleeding and returning to normal hemodynamic status in 16/17 patients (94%). In 1/17 patient (6%), surgery was needed to definitively control the bleeding. The mortality and morbidity rate of TAE at 30 days were 0 and 12%, respectively. Morbidity consisted in coil migration in 1/17 patient (6%) and transient serum liver enzyme elevation in 1/17 patient (6%).<br />Conclusion: TAE is an effective and safe treatment option for ruptured SAPA in hemodynamically unstable patients, with a success rate of 94%. Our results suggest that TAE should be the favored option in patients with hemodynamic instability due to ruptured SAPA.
- Subjects :
- Adult
Aged
Aged, 80 and over
Aneurysm, False diagnostic imaging
Aneurysm, Ruptured diagnostic imaging
Cohort Studies
Contrast Media
Female
Hemodynamics physiology
Hemorrhage diagnostic imaging
Hemorrhage etiology
Hemorrhage therapy
Humans
Male
Middle Aged
Multidetector Computed Tomography
Radiography, Interventional
Retrospective Studies
Shock etiology
Shock physiopathology
Splanchnic Circulation
Treatment Outcome
Aneurysm, False complications
Aneurysm, False therapy
Aneurysm, Ruptured complications
Aneurysm, Ruptured therapy
Embolization, Therapeutic
Mesenteric Arteries diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1432-086X
- Volume :
- 38
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Cardiovascular and interventional radiology
- Publication Type :
- Academic Journal
- Accession number :
- 25338829
- Full Text :
- https://doi.org/10.1007/s00270-014-1002-2