Should endovascular approach be the first line of treatment for retroperitoneal bleeding with hemodynamic shock following percutaneous intervention? A case series.
Catheter Cardiovasc Interv
; 90(1): 104-111, 2017 Jul.
Article
em En
| MEDLINE
| ID: mdl-27566914
ABSTRACT
OBJECTIVES:
To report a series of consecutive patients that developed retroperitoneal hemorrhage (RPH) and persistent hypotension treated with endovascular approach.BACKGROUND:
RPH is a rare complication of percutaneous cardiovascular interventions associated with high morbidity and mortality. The standard approach to treat this complication has been a conservative management for stable patients, and urgent vascular surgery for those with persistent hypovolemic shock. Percutaneous endovascular treatment has evolved as an alternative treatment option.METHODS:
We implemented a management algorithm for patients with suspected RPH and persistent hypotension which embraced systematic use of emergency endovascular evaluation and treatment following clinical assessment without the use of non-invasive diagnostic testing. We report a series of 8 consecutive patients that developed RPH with persistent hypotension.RESULTS:
Successful percutaneous treatment was achieved in all cases with the use of a covered stent. No patient required vascular surgery. The average blood transfusion was 3.4 ± 2.7 units per patient. There were no deaths; one patient experienced acute stent thrombosis that was successfully treated via endovascular approach. At 1-year follow-up, no further events were reported.CONCLUSION:
The incorporation of a standardized protocol using only clinical evaluation followed by emergency percutaneous approach without delays attributed to non-invasive diagnostic work-up showed to be feasible and associated with favorable outcomes. © 2016 Wiley Periodicals, Inc.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Métodos Terapêuticos e Terapias MTCI:
Plantas_medicinales
Assunto principal:
Choque Hemorrágico
/
Procedimentos Endovasculares
/
Intervenção Coronária Percutânea
/
Hemodinâmica
/
Hemorragia
/
Hipotensão
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Guideline
Idioma:
En
Revista:
Catheter Cardiovasc Interv
Ano de publicação:
2017
Tipo de documento:
Article