Keywords:
Interventional non-vascular, CT, Ultrasound, Drainage, Haemorrhage
Authors:
S. Findakly, P. Marovic, H. Kavnoudias, J. Seah; Melbourne, VIC/AU
DOI:
10.26044/ranzcr2021/R-0382
Results
The search criteria yielded 224 patients, of these, 130 patients were confirmed to have undergone a radiologically guided haematoma drainage. 121 of these were performed under ultrasound guidance and 9 under CT guidance.
Post-operative iatrogenic haematomas were the most common reason for a drainage request, accounting for 55.4% of cases (Fig. 1), while lower limb haematomas were the most common body region, representing 29.2% of cases (Fig. 2).
Needle aspiration was the most common method of drainage, accounting for 64.6% of drainages, while a catheter/drain tube insertion was the next most common method (33.1%). A 21 gauge needle was the most commonly used needle.
34 patients (26.2%) had a re-accumulation of their collection, with 21 of these patients (61.8%) either having a repeat percutaneous drainage or other surgical intervention (Fig. 3). Chest wall and back haematomas had the highest rate of re-accumulation (50%) (Fig 4), while post-operative/iatrogenic causes for a haematoma were the most common underlying aetiology for a re-accumulation (29.2%).
There was a statistically significant difference for successful drainages between the two main drainage methods, with 75% of patients who had their haematoma drained via needle aspiration not requiring a repeat intervention, compared to 69.8% of those who had a catheter/drain tube inserted (p=0.049). (Fig. 5).
There were no statistically significant differences in the platelet count, international normalized ratio (INR), or the anticoagulation/antiplatelet profile between patients who had a re-accumulation of their collection and those who did not. All patients who had a re-accumulation of their collection had their peri-procedural anticoagulation appropriately managed as per hospital guidelines.
There was also no statistically significant difference in re-accumulation rates based on a patients age (p=0.397).
24 of the total aspirates (17.7%) grew a positive bacterial or fungal culture. There was no statistically significant difference in the rate of positive cultures between needle aspirations and catheter/drain tube insertions (p=0.194).