The utility of transarterial embolization and computed tomography for life-threatening spontaneous retroperitoneal hemorrhage.
Jpn J Radiol
; 37(4): 328-335, 2019 Apr.
Article
em En
| MEDLINE
| ID: mdl-30701406
ABSTRACT
PURPOSE:
To assess the safety and efficacy of transarterial embolization (TAE) and to evaluate the utility of contrast-enhanced computed tomography (CE-CT) for life-threatening spontaneous retroperitoneal hemorrhage (SRH).METHODS:
Nineteen patients underwent TAE following CE-CT for life-threatening SRH. CE-CT and angiographic findings, technical successes, and clinical successes were evaluated. The diagnostic performance of CE-CT for the detection of active bleeding arteries was also assessed by two independent readers.RESULTS:
Active extravasation of contrast material was accurately observed in 78.9â84.2% of the patients on CE-CT. Angiograms revealed active extravasation in 37 arteries of 15 patients (78.9%), and 4 patients showed no sign of active bleeding. Sensitivity, positive predictive value, and accuracy rate of CE-CT for the detection of active bleeding vessels was 59.5%, 62.9â71.0% and 55.6â60.0% respectively. The successful embolization of 48 intended arteries was achieved in all the patients, including empirical TAE in four patients. Hemodynamic stabilization was achieved in 17 patients (89.5%) with a significant decrease in transfusion (p < 0.001).CONCLUSION:
TAE is a technically safe and clinically effective treatment method for life-threatening SRH. CE-CT has moderate capability for accurate identification of active bleeding arteries. TAE including arteries that potentially distribute anatomic territory of the hematoma is essential.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Tomografia Computadorizada por Raios X
/
Embolização Terapêutica
/
Hemorragia
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article