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CardioVascular and Interventional Radiology

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01-09-2018 | Clinical Investigation

Transcatheter Arterial Embolization for Postoperative Bleeding Following Abdominal Surgery

Authors: Shohei Chatani, Akitoshi Inoue, Shinichi Ohta, Kai Takaki, Shigetaka Sato, Takayasu Iwai, Yoko Murakami, Shobu Watanabe, Akinaga Sonoda, Norihisa Nitta, Hiromitsu Maehira, Masaji Tani, Kiyoshi Murata

Published in: CardioVascular and Interventional Radiology | Issue 9/2018

Abstract

Purpose

We aimed to estimate the usefulness of transcatheter arterial embolization (TAE) in patients with postoperative abdominal hemorrhage and to evaluate the effects of pancreatic fistula on clinical outcomes and angiographic findings.

Materials and Methods

We enrolled 22 patients (20 males and 2 females; mean age 63 years; range 25–86 years), who underwent transarterial angiography for postoperative hemorrhage after abdominal surgery. This group corresponded to 28 procedures. Technical and clinical success rates were calculated, and clinical findings and outcomes were compared between patients with and without a pancreatic fistula.

Results

Pre-interventional CT was performed in all patients before first angiography, and the location of the bleeding was identified in all but one patient. Active arterial bleeding, identified by extravasation of contrast agent (n = 12), pseudoaneurysm formation (n = 12), and arterial wall irregularity (n = 2) were detected in 28 angiographic procedures, and embolization was performed in 26 instances. Various embolization techniques such as isolation, packing, embolization, and stentgraft implantation were performed. The technical and clinical success rates were 96% (25/26 procedures) and 82% (18/22 patients), respectively. In hemodynamically unstable patients (shock index: heart rate/systolic blood pressure > 1), a 92% (12/13 cases) technical success rate was achieved. There were no significant differences in any evaluated parameters between patients with and without pancreatic fistula.

Conclusion

TAE is a safe and effective for treating postoperative hemorrhage even in patients with hemodynamic instability and pancreatic fistula. Additionally, pre-interventional CT is useful for effective, consecutive interventions.

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Title: Transcatheter Arterial Embolization for Postoperative Bleeding Following Abdominal Surgery
Authors: Shohei Chatani
Akitoshi Inoue
Shinichi Ohta
Kai Takaki
Shigetaka Sato
Takayasu Iwai
Yoko Murakami
Shobu Watanabe
Akinaga Sonoda
Norihisa Nitta
Hiromitsu Maehira
Masaji Tani
Kiyoshi Murata
Publication date: 01-09-2018
Publisher: Springer US
Published in: CardioVascular and Interventional Radiology / Issue 9/2018
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-018-2019-8

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Transcatheter Arterial Embolization for Postoperative Bleeding Following Abdominal Surgery

Abstract

Purpose

Materials and Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Materials and Methods

Results

Conclusion

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