Oh Chang Hoon, Cho Soo Buem, Kwon Hyeyoung
Department of Radiology, Ewha Womans Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea.
Department of Radiology, Ewha Womans Seoul Hospital, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea.
J Clin Med. 2024 Jun 4;13(11):3317. doi: 10.3390/jcm13113317.
We aimed to assess the effectiveness and safety of transcatheter arterial embolization (TAE) in the management of spontaneous or traumatic psoas and/or retroperitoneal hemorrhage. This single-center retrospective study enrolled 36 patients who underwent TAE for the treatment of psoas and/or retroperitoneal hemorrhage between May 2016 and February 2024. The patients' mean age was 61.3 years. The spontaneous group (SG, 47.1%) showed higher rates of anticoagulation therapy use compared with the trauma group (TG, 15.8%) ( = 0.042). The TG (94.7%) demonstrated higher survival rates compared with the SG (64.7%; = 0.023). Clinical failure was significantly associated with the liver cirrhosis ( = 0.001), prothrombin time ( = 0.004), and international normalized ratio ( = 0.007) in SG and pRBC transfusion ( = 0.008) in TG. Liver cirrhosis (OR (95% CI): 55.055 (2.439-1242.650), = 0.012) was the only identified independent risk factor for primary clinical failure in the multivariate logistic regression analysis. TAE was a safe and effective treatment for psoas and/or retroperitoneal hemorrhage, regardless of the cause of bleeding. However, liver cirrhosis or the need for massive transfusion due to hemorrhage increased the risk of clinical failure and mortality, necessitating aggressive monitoring and treatment.
我们旨在评估经导管动脉栓塞术（TAE）治疗自发性或创伤性腰大肌和/或腹膜后出血的有效性和安全性。这项单中心回顾性研究纳入了2016年5月至2024年2月期间接受TAE治疗腰大肌和/或腹膜后出血的36例患者。患者的平均年龄为61.3岁。与创伤组（TG，15.8%）相比，自发性组（SG，47.1%）抗凝治疗的使用率更高（P = 0.042）。与SG组（64.7%；P = 0.023）相比，TG组（94.7%）的生存率更高。临床失败与SG组的肝硬化（P = 0.001）、凝血酶原时间（P = 0.004）、国际标准化比值（P = 0.007）以及TG组的红细胞悬液输注（P = 0.008）显著相关。在多因素逻辑回归分析中，肝硬化（OR（95%CI）：55.055（2.439 - 1242.650），P = 0.012）是唯一确定的原发性临床失败的独立危险因素。无论出血原因如何，TAE都是治疗腰大肌和/或腹膜后出血的安全有效方法。然而，肝硬化或因出血需要大量输血会增加临床失败和死亡的风险，需要积极监测和治疗。
