A Multicenter Retrospective Cohort Study Evaluating the Clinical Outcomes of Patients with Coagulopathy Undergoing Transcatheter Arterial Embolization (TAE) for Acute Non-Neurovascular Bleeding
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Treatment
2.3. Outcomes and Definitions
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
References
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Variables | All Patients (n = 120) |
---|---|
Age (years) | 63.6 (±15.9) |
Sex (M/F) | 78 (65.0%)/42 (35%) |
BMI | 26.4 (±3.7) |
eGFR (mL/min) | 68.7 (±24.1) |
CKD Stage | 2 (1–3) |
INR | 1.6 (±0.3) |
aPTT (s) | 46.2 (±5.7) |
PT (s) | 15.8 (±2.6) |
Platelet count (No. ×103/μL) | 206.7 (±163.6) |
Coagulopathy
| 72 (60.0%) 72 (60.0%) 66 (55.0%) |
Hemoglobin (g/dL) | 7.8 (±0.8) |
CT-angiography execution | 117 (97.5%) |
Bleeding on CT-angiography | 111 (92.5%) |
Hematoma volume (mL) | 238.6 (±263.3) |
Antiplatelet therapy
| 18 (15.0%) 12 (10.0%) 5 (5%) |
Anticoagulant therapy | 81 (67.5%) |
Antiplatelet AND anticoagulant therapy | 0 (0%) |
Antiplatelet OR nticoagulant therapy | 99 (82.5%) |
Variables | All Patients (n = 120) |
---|---|
Bleeding on XA | 117 (97.5%) |
Blind embolization | 3 (2.5%) |
Site of bleeding
| 3 (2.5%) 12 (10.0%) 87 (72.5%) 12 (10.0%) 6 (5.0%) |
Number of embolized vessels | 1.1 (±0.4) |
Embolic agent
| 12 (10.0%) 27 (22.5%) 30 (25.0%) 24 (20.0%) 27 (22.5%) |
Intraoperative contrast medium (mL) | 38.1 (±14) |
Volume-of-contrast-to-creatinine-clearance ratio | 0.73 (±0.7) |
Vascular access site
| 84 (70.0%) 30 (25.0%) 6 (5%) |
Sheath diameter, 4F/5F/6F/≥7F | 15 (12.5%)/102 (85%)/3 (2.5%)/0 (0%) |
CT-to-groin time (min) | 52.8 (±58.7) |
Procedure time (min) | 30.7 (±10.5) |
CT-to-embolization time (min) | 83.8 (±59.2) |
Fluoroscopy time (min) | 8.3 (±3.4) |
Cumulative air kerma (mGy) | 159.7 (±62) |
Dose area product (DAP) (Gy/cm2) | 25.5 (±9.7) |
Variables | All Patients (n = 120) |
---|---|
Technical success | 120 (100%) |
Clinical success | 111 (92.5%) |
Coagulopathy correction within 24 h of TAE | 57 (47.5%) |
Vascular access site hemostasis
| 63 (52.5%) 57 (47.5%) |
Units of packed red blood cells transfused per patient | 1.4 (±1.2) |
Rebleeding | 9 (7.5%) |
Non-target embolization | 0 (0%) |
Complications | 12 (10%) |
Vascular access-site complications (VASCs) | 6 (5%) |
Complications, according to SIR classifications
| 108 (90%) 12 (10%) 0 (0%) |
Complications, according to CIRSE classification
| 108 (90%) 12 (10%) |
Treatment required for complications
| 108 (90%) 6 (5%) 6 (5%) 0 (0%) |
30 day bleeding-related mortality | 6 (5%) |
Variables | Group 1 (n° = 63) | Group 2 (n° = 57) | p-Value |
---|---|---|---|
Preoperative INR | 1.59 (±0.3) | 1.52 (±0.3) | 0.242 |
Platelet count (No. ×103/μL) | 202.4 (±166) | 211.3 (±162.3) | 0.9263 |
Preoperative hemoglobin (g/dL) | 7.6 (±0.5) | 7.9 (±0.9) | 0.0419 |
Anticoagulant therapy | 27 (42.9%) | 54 (94.7%) | <0.0001 |
Hematoma volume (mL) | 183.4 (±253.7) | 303.5 (±261.9) | <0.0001 |
CT-to-groin time (min) | 41.6 (±46.4) | 64.6 (±67.8) | 0.0107 |
Procedure time (min) | 29.1 (±10.2) | 32.4 (±10.6) | 0.0523 |
Fluoroscopy time (min) | 7.7 (±2.8) | 9 (±3.8) | 0.0135 |
Technical success | 63 (100%) | 57 (100%) | 1 |
Clinical success | 54 (85.7%) | 57 (100%) | 0.0031 |
Rebleeding rate | 9 (14.3%) | 0 (0%) | 0.0031 |
Complications | 9 (14.3%) | 3 (5.3%) | 0.1317 |
30 day bleeding-related mortality | 6 (9.5%) | 0 (0%) | 0.0285 |
Variables | Coagulopathy (n° = 120) | Normal Coagulation Function (n° = 120) | p-Value |
---|---|---|---|
Age (years) | 63.6 (±15.9) | 55.9 (±20.3) | 0.009 |
Preoperative INR (s) | 1.6 (±0.3) | 1.3 (±0.3) | <0.001 |
Platelet count (No. ×103/μL) | 206.7 (±163.6) | 357.4 (±111) | <0.001 |
Preoperative hemoglobin (g/dL) | 7.8 (±0.8) | 7.7 (±0.8) | 0.397 |
Procedure time (min) | 30.7 (±10.5) | 28.4 (±9) | 0.141 |
Technical success | 120 (100%) | 117 (97.5%) | 0.247 |
Clinical success | 111 (92.5%) | 114 (95%) | 0.595 |
Rebleeding rate | 9 (7.5%) | 10 (8.3%) | 0.811 |
Complications | 12 (10%) | 9 (7.5%) | 0.649 |
30 day bleeding-related mortality | 6 (5%) | 5 (4.2%) | 0.758 |
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Minici, R.; Fontana, F.; Venturini, M.; Guzzardi, G.; Piacentino, F.; Spinetta, M.; Bertucci, B.; Serra, R.; Costa, D.; Ielapi, N.; et al. A Multicenter Retrospective Cohort Study Evaluating the Clinical Outcomes of Patients with Coagulopathy Undergoing Transcatheter Arterial Embolization (TAE) for Acute Non-Neurovascular Bleeding. Medicina 2023, 59, 1333. https://doi.org/10.3390/medicina59071333
Minici R, Fontana F, Venturini M, Guzzardi G, Piacentino F, Spinetta M, Bertucci B, Serra R, Costa D, Ielapi N, et al. A Multicenter Retrospective Cohort Study Evaluating the Clinical Outcomes of Patients with Coagulopathy Undergoing Transcatheter Arterial Embolization (TAE) for Acute Non-Neurovascular Bleeding. Medicina. 2023; 59(7):1333. https://doi.org/10.3390/medicina59071333
Chicago/Turabian StyleMinici, Roberto, Federico Fontana, Massimo Venturini, Giuseppe Guzzardi, Filippo Piacentino, Marco Spinetta, Bernardo Bertucci, Raffaele Serra, Davide Costa, Nicola Ielapi, and et al. 2023. "A Multicenter Retrospective Cohort Study Evaluating the Clinical Outcomes of Patients with Coagulopathy Undergoing Transcatheter Arterial Embolization (TAE) for Acute Non-Neurovascular Bleeding" Medicina 59, no. 7: 1333. https://doi.org/10.3390/medicina59071333