Spontaneous Intramuscular Hematomas of the Abdomen and Pelvis: A New Multilevel Algorithm to Direct Transarterial Embolization and Patient Management View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-02-07

AUTHORS

Milen Popov, Charalampos Sotiriadis, Frederique Gay, Anne-Marie Jouannic, Yann Lachenal, Steven D. Hajdu, Francesco Doenz, Salah D. Qanadli

ABSTRACT

PurposeTo report our experience using a multilevel patient management algorithm to direct transarterial embolization (TAE) in managing spontaneous intramuscular hematoma (SIMH).Materials and MethodsFrom May 2006 to January 2014, twenty-seven patients with SIMH had been referred for TAE to our Radiology department. Clinical status and coagulation characteristics of the patients are analyzed. An algorithm integrating CT findings is suggested to manage SIMH. Patients were classified into three groups: Type I, SIMH with no active bleeding (AB); Type II, SIMH with AB and no muscular fascia rupture (MFR); and Type III, SIMH with MFR and AB. Type II is furthermore subcategorized as IIa, IIb and IIc. Types IIb, IIc and III were considered for TAE. The method of embolization as well as the material been used are described. Continuous variables are presented as mean ± SD. Categorical variables are reported as percentages. Technical success, clinical success, complications and 30-day mortality (d30 M) were analyzed.ResultsTwo patients (7.5%) had Type IIb, four (15%) Type IIc and 21 (77.5%) presented Type III. The detailed CT and CTA findings, embolization procedure and materials used are described. Technical success was 96% with a complication rate of 4%. Clinical success was 88%. The bleeding-related thirty-day mortality was 15% (all with Type III).ConclusionTAE is a safe and efficient technique to control bleeding that should be considered in selected SIMH as soon as possible. The proposed algorithm integrating CT features provides a comprehensive chart to select patients for TAE.Level of Evidence4. More... »

PAGES

537-545

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00270-017-1590-8

DOI

http://dx.doi.org/10.1007/s00270-017-1590-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1083698232

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28175973


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