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Endovascular Management of Hemarthrosis in Patients with Bleeding Diatheses: Systematic Review

  • Srinidhi Shanmugasundaram
  • Vishnu Chandra
  • Marcin Kolber
  • Abhishek Kumar
  • Sohail Contractor
  • Pratik A. ShuklaEmail author
Review
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Abstract

Purpose

In this systematic review, we report the safety and efficacy of embolization for treating hemarthrosis in patients with bleeding diatheses with or without a history of prior arthroplasty.

Materials and Methods

A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. A structured search was performed in PubMed, Web of Science, MEDLINE, and SCOPUS databases of patients undergoing embolization for hemarthrosis. Demographic data, clinical history, angiographic findings, interventions, and outcomes were extracted and tabulated.

Results

The search identified 97 unique titles of which 15 were deemed relevant comprising 78 patients with coagulopathies undergoing 93 embolization procedures. Mean follow-up time was 29 months (range 3–116.5). In the 29 patients who underwent arthroplasty prior to embolization for hemarthrosis, there were 11 bleeding recurrences (37.9%). Of these patients who experienced recurrences, 10 underwent repeat embolization as coagulation factor replacement was not sufficient to address the re-bleeding. In the 49 patients with bleeding diatheses who underwent embolization for hemarthrosis with no history of prior arthroplasty, there were 11 recurrences (22.4%) and 4 of these patients underwent repeat embolization with favorable results. There were four major procedure-related complications.

Conclusion

Transarterial embolization is safe and effective in addressing recurrent hemarthrosis in patients with bleeding diatheses with or without a history of arthroplasty of the affected joint.

Keywords

Hemarthrosis Arthroplasty Hemophilia Embolization 

Notes

Funding

This study was not supported by any funding.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human Participants or Animals

This article does not contain any studies with human participants or animals performed by any of the authors.

Ethical Approval

This study was exempt from institutional review board review.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2019

Authors and Affiliations

  • Srinidhi Shanmugasundaram
    • 1
  • Vishnu Chandra
    • 1
  • Marcin Kolber
    • 2
  • Abhishek Kumar
    • 1
  • Sohail Contractor
    • 1
  • Pratik A. Shukla
    • 1
    Email author
  1. 1.Division of Vascular and Interventional Radiology, Department of RadiologyRutgers – New Jersey Medical SchoolNewarkUSA
  2. 2.Division of Interventional Radiology, Department of RadiologyUT Southwestern Medical CenterDallasUSA

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