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- W2033992488 abstract "The number of patients taking anticoagulants is increasing. Spontaneous extraperitoneal hemorrhage(SEH) is usually due to small vessel disease and thus not amenable to surgical treatment. The largest single study in the current literature addressing Interventional Radiological based treatment of SEH is a case series of 10 patients. The purpose of this study was to evaluate the clinical outcomes of transcatheter arterial embolization for treatment of SEH. An IRB approved, HIPAA compliant retrospective analysis was performed. Between 1998 and 2009, 25 patients (Mean age 64 years; 13 male) with 28 spontaneous extraperitoneal bleeding events were referred for angiography. Each event in individual patients was at least 1 month apart and in a different vascular territory. All had a CT scan demonstrating extraperitoneal hematoma. The following parameters were recorded: location, presence of contrast extravasation or hematocrit level on CT, time between CT and angiography, angiographic findings, vessels embolized, angiographic outcome, transfusion requirements, mortality, and patients' medications. The referral rate for SEH increased from 0.8 per year in the first 5 years to 3 per year in the last 6 years and 7 in the last year. In 20 of 28 events patients were on anticoagulant medication. Angiography demonstrated extravasation in 22 of 28(79%) cases. Angiographic cessation of bleeding was achieved in all 22 cases. In 17(61%) cases there was extravasation from more than one vessel. Bleeding in more than one vascular territory was noted in 8(29%) cases. Empiric embolization based on the location of the hematoma was performed in a further 3 cases. In the 48 hours following angiography transfusion requirements decreased in 27 of 28 cases and there were no deaths. Mean follow up was 37.4 months(range 2-132). All cause mortality at 30 days, 90 days and 12 months was 28.6%, 36% and 54.5% respectively. There were no procedure-related complications. The referral rate of patients with SEH for angiography is increasing. Multiple bleeding sites are typical. Transcatheter embolization is safe and effective. Despite this SEH carries a poor prognosis from other co-morbidities." @default.
- W2033992488 created "2016-06-24" @default.
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- W2033992488 date "2010-02-01" @default.
- W2033992488 modified "2023-10-17" @default.
- W2033992488 title "Abstract No. 201: Transcatheter arterial embolization of spontaneous life threatening extraperitoneal hemorrhage" @default.
- W2033992488 doi "https://doi.org/10.1016/j.jvir.2009.12.363" @default.
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