Bernardinello Valentina, Barbiero Giulio, Battistel Michele, Dengo Caterina, Stramare Roberto, Folino Giulio, Bejko Jonida, Carrozzini Massimiliano, Tarzia Vincenzo, Gerosa Gino, Bottio Tomaso
Department of Medicine DIMED, Institute of Radiology, Via Giustiniani 2, 35128, Padova, Italy.
Radiology, M. Bufalini Hospital, Viale Ghirotti 286, 47521, Cesena, Italy.
CVIR Endovasc. 2019 Dec 9;2(1):40. doi: 10.1186/s42155-019-0085-x.
Severe spontaneous bleeding is a significant complication in patients with continuous flow left ventricular assist devices; there is little evidence on endovascular treatment to support its use.
We observed seven patients (five men, two women, age 43-67 years) with continuous flow left ventricular assist devices on antiaggregant/coagulant therapy, admitted to our hospital for uncorrectable symptomatic anemia; CT-angiography and diagnostic angiography confirmed the presence of atraumatic arterious bleeding from the gastrointestinal tract (six patients), from the intercostal artery and from the bronchial tree (one patient).
All patients where successfully treated via an endovascular approach with superselective embolization of the involved arterial branches with coils and particles.
Spontaneous atraumatic bleeding is a frequent complication in patients with continuous flow left ventricular assist devices; endovascular treatment represents a promising alternative to the surgical approach as it is less invasive, easily repeatable and associated to a reduced procedural risk.
严重自发性出血是连续流左心室辅助装置患者的一种重要并发症；几乎没有血管内治疗的证据支持其应用。
我们观察了7例（5例男性，2例女性，年龄43 - 67岁）接受抗聚集/抗凝治疗的连续流左心室辅助装置患者，因无法纠正的症状性贫血入住我院；CT血管造影和诊断性血管造影证实存在来自胃肠道（6例患者）、肋间动脉和支气管树（1例患者）的非创伤性动脉出血。
所有患者均通过血管内方法成功治疗，采用弹簧圈和微粒对受累动脉分支进行超选择性栓塞。
自发性非创伤性出血是连续流左心室辅助装置患者的常见并发症；血管内治疗是一种有前景的手术替代方法，因为它侵入性较小、易于重复且手术风险降低。
