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01-04-2019 | Computed Tomography | Original Article

The utility of transarterial embolization and computed tomography for life-threatening spontaneous retroperitoneal hemorrhage

Authors: Ryuichiro Tani, Keitaro Sofue, Koji Sugimoto, Naoto Katayama, Mostafa A. S. Hamada, Koji Maruyama, Hiroki Horinouchi, Tomoyuki Gentsu, Koji Sasaki, Eisuke Ueshima, Yutaka Koide, Takuya Okada, Masato Yamaguchi, Takamichi Murakami

Published in: Japanese Journal of Radiology | Issue 4/2019

Abstract

Purpose

To assess the safety and efficacy of transarterial embolization (TAE) and to evaluate the utility of contrast-enhanced computed tomography (CE-CT) for life-threatening spontaneous retroperitoneal hemorrhage (SRH).

Methods

Nineteen patients underwent TAE following CE-CT for life-threatening SRH. CE-CT and angiographic findings, technical successes, and clinical successes were evaluated. The diagnostic performance of CE-CT for the detection of active bleeding arteries was also assessed by two independent readers.

Results

Active extravasation of contrast material was accurately observed in 78.9‒84.2% of the patients on CE-CT. Angiograms revealed active extravasation in 37 arteries of 15 patients (78.9%), and 4 patients showed no sign of active bleeding. Sensitivity, positive predictive value, and accuracy rate of CE-CT for the detection of active bleeding vessels was 59.5%, 62.9‒71.0% and 55.6‒60.0% respectively. The successful embolization of 48 intended arteries was achieved in all the patients, including empirical TAE in four patients. Hemodynamic stabilization was achieved in 17 patients (89.5%) with a significant decrease in transfusion (p < 0.001).

Conclusion

TAE is a technically safe and clinically effective treatment method for life-threatening SRH. CE-CT has moderate capability for accurate identification of active bleeding arteries. TAE including arteries that potentially distribute anatomic territory of the hematoma is essential.

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Title: The utility of transarterial embolization and computed tomography for life-threatening spontaneous retroperitoneal hemorrhage
Authors: Ryuichiro Tani
Keitaro Sofue
Koji Sugimoto
Naoto Katayama
Mostafa A. S. Hamada
Koji Maruyama
Hiroki Horinouchi
Tomoyuki Gentsu
Koji Sasaki
Eisuke Ueshima
Yutaka Koide
Takuya Okada
Masato Yamaguchi
Takamichi Murakami
Publication date: 01-04-2019
Publisher: Springer Japan
Keywords: Computed Tomography
Computed Tomography
Hematoma
Published in: Japanese Journal of Radiology / Issue 4/2019
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI: https://doi.org/10.1007/s11604-019-00815-5

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Springer Medicine

The utility of transarterial embolization and computed tomography for life-threatening spontaneous retroperitoneal hemorrhage

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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