Spontaneous Intramuscular Hematomas of the Abdomen and Pelvis: A New Multilevel Algorithm to Direct Transarterial Embolization and Patient Management.

Détails

ID Serval
serval:BIB_49506DE04100
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Spontaneous Intramuscular Hematomas of the Abdomen and Pelvis: A New Multilevel Algorithm to Direct Transarterial Embolization and Patient Management.
Périodique
Cardiovascular and interventional radiology
Auteur(s)
Popov M., Sotiriadis C., Gay F., Jouannic A.M., Lachenal Y., Hajdu S.D., Doenz F., Qanadli S.D.
ISSN
1432-086X (Electronic)
ISSN-L
0174-1551
Statut éditorial
Publié
Date de publication
04/2017
Peer-reviewed
Oui
Volume
40
Numéro
4
Pages
537-545
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
To report our experience using a multilevel patient management algorithm to direct transarterial embolization (TAE) in managing spontaneous intramuscular hematoma (SIMH).
From May 2006 to January 2014, twenty-seven patients with SIMH had been referred for TAE to our Radiology department. Clinical status and coagulation characteristics of the patients are analyzed. An algorithm integrating CT findings is suggested to manage SIMH. Patients were classified into three groups: Type I, SIMH with no active bleeding (AB); Type II, SIMH with AB and no muscular fascia rupture (MFR); and Type III, SIMH with MFR and AB. Type II is furthermore subcategorized as IIa, IIb and IIc. Types IIb, IIc and III were considered for TAE. The method of embolization as well as the material been used are described. Continuous variables are presented as mean ± SD. Categorical variables are reported as percentages. Technical success, clinical success, complications and 30-day mortality (d30 M) were analyzed.
Two patients (7.5%) had Type IIb, four (15%) Type IIc and 21 (77.5%) presented Type III. The detailed CT and CTA findings, embolization procedure and materials used are described. Technical success was 96% with a complication rate of 4%. Clinical success was 88%. The bleeding-related thirty-day mortality was 15% (all with Type III).
TAE is a safe and efficient technique to control bleeding that should be considered in selected SIMH as soon as possible. The proposed algorithm integrating CT features provides a comprehensive chart to select patients for TAE.
4.

Mots-clé
Abdomen/blood supply, Abdomen/diagnostic imaging, Aged, Aged, 80 and over, Algorithms, Computed Tomography Angiography, Embolization, Therapeutic/methods, Female, Hematoma/diagnostic imaging, Hematoma/therapy, Humans, Male, Middle Aged, Muscle, Skeletal/blood supply, Muscle, Skeletal/diagnostic imaging, Muscular Diseases/diagnostic imaging, Muscular Diseases/therapy, Pelvis/blood supply, Pelvis/diagnostic imaging, Treatment Outcome
Pubmed
Création de la notice
10/02/2017 17:17
Dernière modification de la notice
20/08/2019 14:56
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