Combined DSA- and US-guided management of acute bleeding : effectiveness of percutaneous glue embolization in six cases
© 2023. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB)..
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.
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.
RESULTS: Both technical and clinical successes were obtained in 100% of the cases without major complications. No needle occlusion occurred during glue injection.
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:27 |
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| Enthalten in: |
Journal of ultrasound - 27(2024), 1 vom: 29. März, Seite 179-184 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Giurazza, Francesco [VerfasserIn] |
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| Links: |
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| Themen: |
Direct puncture |
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| Anmerkungen: |
Date Completed 04.03.2024 Date Revised 05.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s40477-023-00785-5 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM356656489 |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB). | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a RESULTS: Both technical and clinical successes were obtained in 100% of the cases without major complications. No needle occlusion occurred during glue injection | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Direct puncture | |
| 650 | 4 | |a Embolization | |
| 650 | 4 | |a Glue | |
| 650 | 4 | |a Hemorrhage | |
| 650 | 4 | |a Ultrasound-guidance | |
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| 700 | 1 | |a Di Serafino, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Niola, Raffaella |e verfasserin |4 aut | |
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