Nicola Tamburini1, Nicole Carriel2, Giorgio Cavallesco1, Laureano Molins2,3, Roberto Galeotti4, Rudith Guzmán2, Elisabetta Salviato4, David Sánchez-Lorente2, Elisa Maietti5,6, Pio Maniscalco1, Marc Boada2. 1. Department of Morphology, Experimental Medicine and Surgery, Section of Chirurgia 1, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy. 2. General Thoracic Surgery Department, Respiratory Institute, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain. 3. Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. 4. Department of Radiology, Section of Interventional Radiology, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy. 5. Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy. 6. Center for Clinical Epidemiology, Department of Medical Science, University of Ferrara, Ferrara, Italy.
Abstract
BACKGROUND: To evaluate the clinical efficacy and identify the predictors of outcome of intercostal arterial embolization for hemothorax caused by intercostal artery (ICA) injuries. METHODS: A retrospective multi-institutional study was conducted. Outcomes were analyzed in 30 consecutive patients presenting with hemothorax caused by active ICA hemorrhage undergoing transcatheter arterial embolization (TAE). Clinical and procedural parameters were compared between outcomes groups. RESULTS: Overall technical success rate was 87% (n=26). Among the 4 failed cases, 2 underwent repeated TAE and 2 underwent additional surgery. Overall 30-day mortality rate was 23%. Low haemoglobin levels and haematocrit, hepatic comorbidities and more than one artery undergoing embolization increased technical failure rate significantly. Survival was poorer in patients with massive bleeding. CONCLUSIONS: ICA embolization was found to be a safe and effective method in treating hemothorax caused by active ICA haemorrhage. Careful pre-embolization evaluation may be required for patient with low haemoglobin levels and haematocrit, hepatic comorbidities and active haemorrhage from more than one artery. 2019 Journal of Thoracic Disease. All rights reserved.
BACKGROUND: To evaluate the clinical efficacy and identify the predictors of outcome of intercostal arterial embolization for hemothorax caused by intercostal artery (ICA) injuries. METHODS: A retrospective multi-institutional study was conducted. Outcomes were analyzed in 30 consecutive patients presenting with hemothorax caused by active ICA hemorrhage undergoing transcatheter arterial embolization (TAE). Clinical and procedural parameters were compared between outcomes groups. RESULTS: Overall technical success rate was 87% (n=26). Among the 4 failed cases, 2 underwent repeated TAE and 2 underwent additional surgery. Overall 30-day mortality rate was 23%. Low haemoglobin levels and haematocrit, hepatic comorbidities and more than one artery undergoing embolization increased technical failure rate significantly. Survival was poorer in patients with massive bleeding. CONCLUSIONS: ICA embolization was found to be a safe and effective method in treating hemothorax caused by active ICA haemorrhage. Careful pre-embolization evaluation may be required for patient with low haemoglobin levels and haematocrit, hepatic comorbidities and active haemorrhage from more than one artery. 2019 Journal of Thoracic Disease. All rights reserved.
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