患有凝血障碍的患者的自发软组织血瘤:跨动脉栓塞的安全性和有效性
Davide Fior1, Stefano Di Provvido2, Davide Leni3
1Department of Radiology, Sant'Anna Hospital, ASST Lariana, Via Ravona 20, San Fermo della Battaglia, 22042 Como, Italy.
概括
皮肤透动脉栓塞 (TAE) 对于具有活跃出血的自发软组织血瘤有效. 虽然对于波波夫2A类是安全的,但对于2B,2C和3类存在更高的死亡风险.
科学领域:
- 干预性放射学 干预性放射学
- 血管外科 血管外科
- 创伤外科 手术 创伤外科
背景情况:
- 自发性软组织血瘤 (SSTH) 与活跃出血,特别是在抗凝药患者中,带来了重大管理挑战.
- 波波夫分类有助于分层SSTH严重程度,指导治疗决策.
研究的目的:
- 评估皮肤穿血动脉栓塞 (TAE) 的安全性和有效性,以治疗有活跃出血的SSTH.
- 分析基于波波夫分类的结果,并确定死亡风险因素.
主要方法:
- 78名SSTH和TAE治疗的活跃出血患者 (2010-2019) 的回顾性分析.
- 患者分为波波夫2A,2B,2C和3类.
- 主要结局:30天生存期;次要结局:技术成功,重新干预,并发症.
主要成果:
- 即时的技术成功率为98.7% (77/78名患者).
- 30天死亡率为19% (15/78名患者),在2B,2C,3类和不稳定的患者中更高.
- 并发症包括急性损伤 (31%) 和动脉穿孔部位损伤 (2.5%).
结论:
- TAE对波波夫2A类SSTH具有活跃出血的有效和安全.
- 与2A相比,在波波夫2B,2C和3类中观察到更高的死亡风险.
- 建议在CT扫描上对所有患有活跃出血SSTH的患者立即考虑TAE.
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