A Multicenter Retrospective Cohort Study Evaluating the Clinical Outcomes of Patients with Coagulopathy Undergoing Transcatheter Arterial Embolization (TAE) for Acute Non-Neurovascular Bleeding
<i>Background and Objectives</i>: Transcatheter arterial embolization (TAE) is the mainstay of treatment for acute major hemorrhage, even in patients with coagulopathy and spontaneous bleeding. Coagulopathy is associated with worsening bleeding severity and higher mortality and clinical...
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MDPI AG
2023-07-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/7/1333 |
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| author | Roberto Minici Federico Fontana Massimo Venturini Giuseppe Guzzardi Filippo Piacentino Marco Spinetta Bernardo Bertucci Raffaele Serra Davide Costa Nicola Ielapi Andrea Coppola Pasquale Guerriero Biagio Apollonio Rita Santoro MGJR Research Team Luca Brunese Domenico Laganà |
| author_facet | Roberto Minici Federico Fontana Massimo Venturini Giuseppe Guzzardi Filippo Piacentino Marco Spinetta Bernardo Bertucci Raffaele Serra Davide Costa Nicola Ielapi Andrea Coppola Pasquale Guerriero Biagio Apollonio Rita Santoro MGJR Research Team Luca Brunese Domenico Laganà |
| author_sort | Roberto Minici |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Transcatheter arterial embolization (TAE) is the mainstay of treatment for acute major hemorrhage, even in patients with coagulopathy and spontaneous bleeding. Coagulopathy is associated with worsening bleeding severity and higher mortality and clinical failure rates. Furthermore, some unanswered questions remain, such as the definition of coagulopathy, the indication for TAE or conservative treatment, and the choice of embolic agent. This study aims to assess the efficacy and safety of TAE for spontaneous non-neurovascular acute bleeding in patients with coagulopathy. <i>Materials and Methods</i>: This study is a multicenter analysis of retrospectively collected data of consecutive patients with coagulopathy who had undergone, from January 2018 to May 2023, transcatheter arterial embolization for the management of spontaneous hemorrhages. <i>Results</i>: During the study interval (January 2018–May 2023), 120 patients with coagulopathy underwent TAE for spontaneous non-neurovascular acute bleeding. The abdominal wall was the most common bleeding site (72.5%). The most commonly used embolic agent was polyvinyl alcohol (PVA) particles or microspheres (25.0%), whereas coils and gelatin sponge together accounted for 32.5% of the embolic agents used. Technical success was achieved in all cases, with a 92.5% clinical success rate related to 9 cases of rebleeding. Complications were recorded in 12 (10%) patients. Clinical success was significantly better in the group of patients who underwent correction of the coagulopathy within 24 h of TAE. <i>Conclusions</i>: Transcatheter arterial embolization (TAE) is effective and safe for the management of acute non-neurovascular bleeding in patients with coagulopathy. Correction of coagulopathy should not delay TAE and vice versa, as better clinical outcomes were noted in the subgroup of patients undergoing correction of coagulopathy within 24 h of TAE. |
| first_indexed | 2024-03-11T00:50:59Z |
| format | Article |
| id | doaj.art-8cb7ec1640ed4642afd84d3127b98c24 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-11T00:50:59Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
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| series | Medicina |
| spelling | doaj.art-8cb7ec1640ed4642afd84d3127b98c242023-11-18T20:25:18ZengMDPI AGMedicina1010-660X1648-91442023-07-01597133310.3390/medicina59071333A Multicenter Retrospective Cohort Study Evaluating the Clinical Outcomes of Patients with Coagulopathy Undergoing Transcatheter Arterial Embolization (TAE) for Acute Non-Neurovascular BleedingRoberto Minici0Federico Fontana1Massimo Venturini2Giuseppe Guzzardi3Filippo Piacentino4Marco Spinetta5Bernardo Bertucci6Raffaele Serra7Davide Costa8Nicola Ielapi9Andrea Coppola10Pasquale Guerriero11Biagio Apollonio12Rita Santoro13MGJR Research Team14Luca Brunese15Domenico Laganà16Radiology Unit, Dulbecco University Hospital, 88100 Catanzaro, ItalyDiagnostic and Interventional Radiology Unit, ASST Settelaghi, Insubria University, 21100 Varese, ItalyDiagnostic and Interventional Radiology Unit, ASST Settelaghi, Insubria University, 21100 Varese, ItalyRadiology Unit, Maggiore della Carità University Hospital, 28100 Novara, ItalyDiagnostic and Interventional Radiology Unit, ASST Settelaghi, Insubria University, 21100 Varese, ItalyRadiology Unit, Maggiore della Carità University Hospital, 28100 Novara, ItalyRadiology Unit, Dulbecco University Hospital, 88100 Catanzaro, ItalyVascular Surgery Unit, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Dulbecco University Hospital, 88100 Catanzaro, ItalyDepartment of Law, Economics and Sociology, Magna Graecia University of Catanzaro, 88100 Catanzaro, ItalyDepartment of Public Health and Infectious Disease, Sapienza University of Rome, 00185 Rome, ItalyDiagnostic and Interventional Radiology Unit, ASST Settelaghi, Insubria University, 21100 Varese, ItalyRadiology Unit, Santobono-Pausilipon Hospital, 80129 Naples, ItalyRadiology Unit, San Timoteo Hospital, 86039 Termoli, ItalyHaemophilia and Thrombosis Center, Dulbecco University Hospital, 88100 Catanzaro, ItalyMagna Graecia Junior Radiologists Research Team, 88100 Catanzaro, ItalyDepartment of Medicine and Health Sciences, University of Molise, 86100 Campobasso, ItalyRadiology Unit, Dulbecco University Hospital, 88100 Catanzaro, Italy<i>Background and Objectives</i>: Transcatheter arterial embolization (TAE) is the mainstay of treatment for acute major hemorrhage, even in patients with coagulopathy and spontaneous bleeding. Coagulopathy is associated with worsening bleeding severity and higher mortality and clinical failure rates. Furthermore, some unanswered questions remain, such as the definition of coagulopathy, the indication for TAE or conservative treatment, and the choice of embolic agent. This study aims to assess the efficacy and safety of TAE for spontaneous non-neurovascular acute bleeding in patients with coagulopathy. <i>Materials and Methods</i>: This study is a multicenter analysis of retrospectively collected data of consecutive patients with coagulopathy who had undergone, from January 2018 to May 2023, transcatheter arterial embolization for the management of spontaneous hemorrhages. <i>Results</i>: During the study interval (January 2018–May 2023), 120 patients with coagulopathy underwent TAE for spontaneous non-neurovascular acute bleeding. The abdominal wall was the most common bleeding site (72.5%). The most commonly used embolic agent was polyvinyl alcohol (PVA) particles or microspheres (25.0%), whereas coils and gelatin sponge together accounted for 32.5% of the embolic agents used. Technical success was achieved in all cases, with a 92.5% clinical success rate related to 9 cases of rebleeding. Complications were recorded in 12 (10%) patients. Clinical success was significantly better in the group of patients who underwent correction of the coagulopathy within 24 h of TAE. <i>Conclusions</i>: Transcatheter arterial embolization (TAE) is effective and safe for the management of acute non-neurovascular bleeding in patients with coagulopathy. Correction of coagulopathy should not delay TAE and vice versa, as better clinical outcomes were noted in the subgroup of patients undergoing correction of coagulopathy within 24 h of TAE.https://www.mdpi.com/1648-9144/59/7/1333coagulopathybleedingTAEembolizationhemorrhageembolic agents |
| spellingShingle | Roberto Minici Federico Fontana Massimo Venturini Giuseppe Guzzardi Filippo Piacentino Marco Spinetta Bernardo Bertucci Raffaele Serra Davide Costa Nicola Ielapi Andrea Coppola Pasquale Guerriero Biagio Apollonio Rita Santoro MGJR Research Team Luca Brunese Domenico Laganà A Multicenter Retrospective Cohort Study Evaluating the Clinical Outcomes of Patients with Coagulopathy Undergoing Transcatheter Arterial Embolization (TAE) for Acute Non-Neurovascular Bleeding Medicina coagulopathy bleeding TAE embolization hemorrhage embolic agents |
| title | A Multicenter Retrospective Cohort Study Evaluating the Clinical Outcomes of Patients with Coagulopathy Undergoing Transcatheter Arterial Embolization (TAE) for Acute Non-Neurovascular Bleeding |
| title_full | A Multicenter Retrospective Cohort Study Evaluating the Clinical Outcomes of Patients with Coagulopathy Undergoing Transcatheter Arterial Embolization (TAE) for Acute Non-Neurovascular Bleeding |
| title_fullStr | A Multicenter Retrospective Cohort Study Evaluating the Clinical Outcomes of Patients with Coagulopathy Undergoing Transcatheter Arterial Embolization (TAE) for Acute Non-Neurovascular Bleeding |
| title_full_unstemmed | A Multicenter Retrospective Cohort Study Evaluating the Clinical Outcomes of Patients with Coagulopathy Undergoing Transcatheter Arterial Embolization (TAE) for Acute Non-Neurovascular Bleeding |
| title_short | A Multicenter Retrospective Cohort Study Evaluating the Clinical Outcomes of Patients with Coagulopathy Undergoing Transcatheter Arterial Embolization (TAE) for Acute Non-Neurovascular Bleeding |
| title_sort | multicenter retrospective cohort study evaluating the clinical outcomes of patients with coagulopathy undergoing transcatheter arterial embolization tae for acute non neurovascular bleeding |
| topic | coagulopathy bleeding TAE embolization hemorrhage embolic agents |
| url | https://www.mdpi.com/1648-9144/59/7/1333 |
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