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Transarterial Embolization for Spontaneous Soft-Tissue Hematomas: Predictive Factors for Early Death

Introduction: The aim of this retrospective monocentric study was to assess the safety and efficacy of spontaneous soft-tissue hematoma transarterial embolization (TAE) and to evaluate predictive factors for early mortality (≤30 days) after TAE for spontaneous soft-tissue hematoma (SSTH). Materials...

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Autores principales: Grange, Rémi, Grange, Lucile, Chevalier, Clément, Mayaud, Alexandre, Villeneuve, Loïc, Boutet, Claire, Grange, Sylvain
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9862993/
https://www.ncbi.nlm.nih.gov/pubmed/36675676
http://dx.doi.org/10.3390/jpm13010015
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author Grange, Rémi
Grange, Lucile
Chevalier, Clément
Mayaud, Alexandre
Villeneuve, Loïc
Boutet, Claire
Grange, Sylvain
author_facet Grange, Rémi
Grange, Lucile
Chevalier, Clément
Mayaud, Alexandre
Villeneuve, Loïc
Boutet, Claire
Grange, Sylvain
author_sort Grange, Rémi
collection PubMed
description Introduction: The aim of this retrospective monocentric study was to assess the safety and efficacy of spontaneous soft-tissue hematoma transarterial embolization (TAE) and to evaluate predictive factors for early mortality (≤30 days) after TAE for spontaneous soft-tissue hematoma (SSTH). Materials and methods: Between January 2010 and March 2022, all patients referred to our hospital for spontaneous soft-tissue hematoma and treated by emergency TAE were reviewed. Inclusion criteria were patients: ≥18-year-old, with active bleeding shown on preoperative multidetector row computed tomography, with spontaneous soft-tissue hematoma, and treated by TAE. Exclusion criteria were patients with soft-tissue hematomas of traumatic, iatrogenic, or tumoral origin. Clinical, biological, and imaging records were reviewed. Imaging data included delimitation of hematoma volume and presence of fluid level. Univariate and multivariate analyses were performed to check for associations with early mortality. Results: Fifty-six patients were included. Median age was 75.5 [9–83] ([Q1–Q3] years and 23 (41.1%) were males. Fifty-one patients (91.1%) received antiplatelet agent and/or anticoagulant therapy. All 56 patients had active bleeding shown on a preoperative CT scan. Thirty-seven (66.0%) hematomas involved the retroperitoneum. Median hemoglobin level was 7.6 [4.4–8.2] g/dL. Gelatine sponge was used in 32/56 (57.1%) procedures. Clinical success was obtained in 48/56 (85.7%) patients and early mortality occurred in 15/56 (26.8%) patients. In univariate and multivariate analysis, retroperitoneal location and volume of hematoma were associated with early mortality. Conclusion: Retroperitoneal location and volume of hematoma seem to be risk factors for early death in the context of TAE for spontaneous soft-tissue hematoma. Larger multicenter studies are necessary to identify others predictive factors for early mortality and to anticipate which patients may benefit from an interventional strategy with TAE.
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spelling pubmed-98629932023-01-22 Transarterial Embolization for Spontaneous Soft-Tissue Hematomas: Predictive Factors for Early Death Grange, Rémi Grange, Lucile Chevalier, Clément Mayaud, Alexandre Villeneuve, Loïc Boutet, Claire Grange, Sylvain J Pers Med Article Introduction: The aim of this retrospective monocentric study was to assess the safety and efficacy of spontaneous soft-tissue hematoma transarterial embolization (TAE) and to evaluate predictive factors for early mortality (≤30 days) after TAE for spontaneous soft-tissue hematoma (SSTH). Materials and methods: Between January 2010 and March 2022, all patients referred to our hospital for spontaneous soft-tissue hematoma and treated by emergency TAE were reviewed. Inclusion criteria were patients: ≥18-year-old, with active bleeding shown on preoperative multidetector row computed tomography, with spontaneous soft-tissue hematoma, and treated by TAE. Exclusion criteria were patients with soft-tissue hematomas of traumatic, iatrogenic, or tumoral origin. Clinical, biological, and imaging records were reviewed. Imaging data included delimitation of hematoma volume and presence of fluid level. Univariate and multivariate analyses were performed to check for associations with early mortality. Results: Fifty-six patients were included. Median age was 75.5 [9–83] ([Q1–Q3] years and 23 (41.1%) were males. Fifty-one patients (91.1%) received antiplatelet agent and/or anticoagulant therapy. All 56 patients had active bleeding shown on a preoperative CT scan. Thirty-seven (66.0%) hematomas involved the retroperitoneum. Median hemoglobin level was 7.6 [4.4–8.2] g/dL. Gelatine sponge was used in 32/56 (57.1%) procedures. Clinical success was obtained in 48/56 (85.7%) patients and early mortality occurred in 15/56 (26.8%) patients. In univariate and multivariate analysis, retroperitoneal location and volume of hematoma were associated with early mortality. Conclusion: Retroperitoneal location and volume of hematoma seem to be risk factors for early death in the context of TAE for spontaneous soft-tissue hematoma. Larger multicenter studies are necessary to identify others predictive factors for early mortality and to anticipate which patients may benefit from an interventional strategy with TAE. MDPI 2022-12-22 /pmc/articles/PMC9862993/ /pubmed/36675676 http://dx.doi.org/10.3390/jpm13010015 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Grange, Rémi
Grange, Lucile
Chevalier, Clément
Mayaud, Alexandre
Villeneuve, Loïc
Boutet, Claire
Grange, Sylvain
Transarterial Embolization for Spontaneous Soft-Tissue Hematomas: Predictive Factors for Early Death
title Transarterial Embolization for Spontaneous Soft-Tissue Hematomas: Predictive Factors for Early Death
title_full Transarterial Embolization for Spontaneous Soft-Tissue Hematomas: Predictive Factors for Early Death
title_fullStr Transarterial Embolization for Spontaneous Soft-Tissue Hematomas: Predictive Factors for Early Death
title_full_unstemmed Transarterial Embolization for Spontaneous Soft-Tissue Hematomas: Predictive Factors for Early Death
title_short Transarterial Embolization for Spontaneous Soft-Tissue Hematomas: Predictive Factors for Early Death
title_sort transarterial embolization for spontaneous soft-tissue hematomas: predictive factors for early death
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9862993/
https://www.ncbi.nlm.nih.gov/pubmed/36675676
http://dx.doi.org/10.3390/jpm13010015
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