Transarterial Embolization for Spontaneous Soft-Tissue Hematomas: Predictive Factors for Early Death.

Area of Science:

• Interventional Radiology
• Vascular Surgery
• Emergency Medicine

Background:

• Spontaneous soft-tissue hematoma (SSTH) is a rare but potentially life-threatening condition.
• Transarterial embolization (TAE) is an established treatment for active bleeding in SSTH.
• Assessing the safety, efficacy, and predictors of mortality after TAE for SSTH is crucial.

Purpose of the Study:

• To evaluate the safety and efficacy of transarterial embolization (TAE) for spontaneous soft-tissue hematoma (SSTH).
• To identify predictive factors associated with early mortality (≤30 days) following TAE for SSTH.

Main Methods:

• Retrospective monocentric study of patients with SSTH treated by emergency TAE (January 2010 - March 2022).
• Inclusion criteria: ≥18 years, active bleeding on CT, SSTH, TAE treatment. Exclusion: traumatic, iatrogenic, or tumoral hematomas.
• Univariate and multivariate analyses were performed to identify associations with early mortality.

Main Results:

• Fifty-six patients were included; 91.1% were on antiplatelet/anticoagulant therapy.
• Clinical success was achieved in 85.7% of patients; early mortality occurred in 26.8%.
• Retroperitoneal location (66.0%) and larger hematoma volume were significantly associated with early mortality.

Conclusions:

• Retroperitoneal location and hematoma volume are significant risk factors for early death after TAE for SSTH.
• Further multicenter studies are needed to identify additional predictive factors for early mortality.
• Identifying patients who may benefit from TAE for SSTH requires further investigation.