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Role of percutaneous transcatheter embolization (PTE) in the treatment of spontaneous bleeding associated with anticoagulant therapy

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Abstract

Purpose

To evaluate safety and clinical efficacy of percutaneous transcatheter embolization (PTE) in the treatment of spontaneous bleedings (SBs) in patients submitted to chronic anticoagulation therapy.

Materials and methods

From January 2007 to December 2012, 20 patients (mean age 75.8 years, range 68–91 years) with 23 SBs were retrospectively evaluated. Active bleeding was documented by contrast enhanced-multidetector row computed tomography (CE-MDCT). PTE was performed using different embolic agents. Technical success (TS), clinical success (CS), late success (LS) and mortality rate (M) related to the angiographic procedure and complications were evaluated.

Results

CE-MDCT and digital subtraction angiography (DSA) identified active bleeding sites in 18 cases (18/20). In two cases (2/20) DSA did not confirm the arterial bleeding diagnosed on CE-MDCT. Twenty-three sessions of PTE were performed. TS, CS, LS and M were, respectively, 100, 85, 15 and 0 %. No major complications were observed.

Conclusions

PTE could be considered a safe and effective “first line” approach to treat SB associated with anticoagulation therapy.

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Conflict of interest

Authors have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Interventional Radiology-Department of Radiology, University of Insubria, Viale Borri 57, 21100, Varese, Italy

    Anna Maria Ierardi, Chiara Floridi, Carlo Pellegrino & Gianpaolo Carrafiello

  2. Department of Radiology, Second University of Naples, Piazza Miraglia 9, 80134, Naples, Italy

    Mario Petrillo, Roberto Grassi & Antonio Rotondo

  3. Department of Diagnostic Radiological Imaging, “A. Cardarelli” Hospital, Naples, Italy

    Antonio Pinto

  4. Department of Radiology, P.O. Pinetagrande, Castel Volturno, Italy

    Isabella Iadevito, Erica Golia & Alessandra Perillo

Authors
  1. Anna Maria Ierardi
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  2. Chiara Floridi
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  3. Carlo Pellegrino
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  4. Mario Petrillo
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  5. Antonio Pinto
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  6. Isabella Iadevito
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  7. Erica Golia
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  8. Alessandra Perillo
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  9. Roberto Grassi
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  10. Antonio Rotondo
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  11. Gianpaolo Carrafiello
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Correspondence to Gianpaolo Carrafiello.

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Ierardi, A.M., Floridi, C., Pellegrino, C. et al. Role of percutaneous transcatheter embolization (PTE) in the treatment of spontaneous bleeding associated with anticoagulant therapy. Radiol med 120, 149–157 (2015). https://doi.org/10.1007/s11547-014-0470-4

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  • DOI: https://doi.org/10.1007/s11547-014-0470-4

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