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Combined DSA- and US-guided management of acute bleeding: effectiveness of percutaneous glue embolization in six cases.
- Source :
-
Journal of ultrasound [J Ultrasound] 2024 Mar; Vol. 27 (1), pp. 179-184. Date of Electronic Publication: 2023 May 10. - Publication Year :
- 2024
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Abstract
- Aims: This study aims to report on safety and effectiveness of glue embolization of acute hemorrhages performed by US-guided percutaneous direct puncture, in patients where the standard endovascular approach is technically unfavourable.<br />Methods: In this single center retrospective analysis, patients affected by traumatic or non traumatic acute hemorrhages were treated with glue embolization technically performed by US-guided direct puncture. Patients suffered from active bleeding detected at contrast-enhanced Computer Tomography and confirmed at Digital Subtracted Arteriography, with concomitant hemoglobin drop and blood pressure reduction. Six patients were reviewed; hemorrhages occurred in liver parenchima (1), gallbladder (1) and lower limbs (4). Bleedings etiologies were post-traumatic (5) and inflammatory (1); four had extraluminal blushes while 2 were pseudoaneurysms. In five cases (4 limbs and 1 hepatic bleedings) the direct-puncture approach was adopted because of technically unfavourable vascular anatomy for superselective embolization; in one case (cystic artery pseudoaneurysm), an endovascular embolization would entail a high risk of gallbladder ischemia because of its terminal arterial supply. Technical success was defined disappearance of bleeding signs at last arteriography; clinical success was considered stabilization and/or improvement of hemoglobin values and arterial pressure without additional interventions.<br />Results: Both technical and clinical successes were obtained in 100% of the cases without major complications. No needle occlusion occurred during glue injection.<br />Conclusions: In this study percutaneous US-guided embolization by direct puncture was a safe and effective approach to manage acute bleedings; it could be considered as an alternative in patients with unfavourable vascular anatomy for the standard catheter-directed endovascular embolization.<br /> (© 2023. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)
Details
- Language :
- English
- ISSN :
- 1876-7931
- Volume :
- 27
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of ultrasound
- Publication Type :
- Academic Journal
- Accession number :
- 37162728
- Full Text :
- https://doi.org/10.1007/s40477-023-00785-5