Aims and objectives
Purpose of this work is to evaluate efficacy and safety of transcatheter embolization (TE) of spontaneous bleeding in the abdominal wall and retroperitoneal muscles and its relationship with anticoagulant/antiplatelet therapy.
Methods and materials
Between March 2010-2017,
31 patients (10 m; 21 f; average age 76 yo) who underwent TE for spontaneous bleeding of abdominal wall/retroperitoneum muscles were retrospectively analyzed. For each patient location of bleeding,
drugs assumed (anticoagulant/antiplatelet therapy),
symptoms and complications were considered [1-2]. On all patients active bleeding was discovered through a CT examination (protocol included: unenhanced CT,
Hematomas and site of bleeding were identified by CT-angiography in all cases (18 retroperitoneal,
13 anterior muscles).
In particular the site of bleeding was lumbar artery in 38% of cases,
epigastric artery (superficial or inferior) in 35% of cases (Figure 4-6),
an hypogastric collateral in 12% of cases; bleeding of both epigastric artery and hypogastric collateral was found in 9% of cases while contemporary bleeding of lumbar artery and hypogastric collateral was found in 6% of cases...
Our data agrees with literature confirming that CT angiography is the gold standard for the diagnosis of spontaneous abdominal bleeding,
which may be a life threating situation [2-6].
Embolization is the first line treatment in these patients. It is a safe,
very useful in critical patient,
especially in frail patients,
that cannot undergo open surgery.
Anticoagulant and antiplatelet therapy is strictly related with the insurgence of spontaneous bleeding although it is not...
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Leal R (2004)Transcatheter Arterial Embolization of Concurrent Spontaneous Hematomas of the Rectus sheath and Psoas...