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Wang ZX, Li L, Zhao YF. Utility of marking and fusion image-guided technique with cone-beam CT in kidney ruptured haemorrhage without extravascular leakage in angiography: a pilot study. Br J Radiol 2024; 97:386-391. [PMID: 38302092 DOI: 10.1093/bjr/tqad060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/23/2023] [Accepted: 12/20/2023] [Indexed: 02/03/2024] Open
Abstract
OBJECTIVE To explore the feasibility of using marking and fusion image-guided technique with cone-beam CT (CBCT) in cases of kidney ruptured haemorrhage without extravascular leakage in digital subtraction angiography (DSA) images. METHODS This is a retrospective case-control study that included 43 patients who underwent transcatheter arterial embolization for kidney ruptured haemorrhage and difficult haemostasis. The patients were divided into two groups: the CBCT group (cases without extravascular leakage observed in angiography) and the control group (cases with clearly identifiable target vessels in angiography). The baseline characteristics and clinical outcomes were collected and analysed. RESULTS The results showed no statistically significant differences in the duration of the procedure and intraoperative blood transfusion between the control and CBCT groups (P > .05). The study clarified that the CBCT group had a significantly higher rate of improvement of gross haematuria compared to the control group (P < .05). The CBCT group showed a greater increase in haemoglobin and a lesser increase in creatinine. The clinical success rates were 87.5% in the control group and 90.9% in the CBCT group (P > .05). CONCLUSIONS The marking and fusion image-guided technique is useful in cases of kidney ruptured haemorrhage without extravascular leakage of contrast agent. The technique is safe, feasible, and effective, and we believe it is superior to purely DSA-guidance. ADVANCES IN KNOWLEDGE The use of the marking and fusion image-guided technique is recommended to overcome the challenge of undetectable target vessels during interventional procedures. This technique is considered as non-inferior to purely DSA-guided interventional procedures where the target vessels are clearly identifiable.
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Affiliation(s)
- Zi-Xuan Wang
- Department of Interventional Radiology, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao 266000, China
| | - Lin Li
- Department of Interventional Radiology, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao 266000, China
| | - Yi-Fan Zhao
- Department of Interventional Radiology, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao 266000, China
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Transcatheter Arterial Embolization with N-butyl-2 Cyanoacrylate Glubran 2 for the Treatment of Acute Renal Hemorrhage Under Coagulopathic Conditions. Ann Vasc Surg 2022; 86:358-365. [DOI: 10.1016/j.avsg.2022.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 03/13/2022] [Accepted: 04/03/2022] [Indexed: 11/24/2022]
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Sgalambro F, Giordano AV, Carducci S, Varrassi M, Perri M, Arrigoni F, Palumbo P, Bruno F, Bardi L, Mangoni di S Stefano ML, Danti G, Gentili F, Mazzei MA, Di Cesare E, Splendiani A, Masciocchi C, Barile A. The role of interventional radiology in hepatic and renal hemorrhage embolization: single center experience and literature review. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021405. [PMID: 34505844 PMCID: PMC8477065 DOI: 10.23750/abm.v92is5.11876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/28/2021] [Indexed: 12/03/2022]
Abstract
Background and aim: Intraabdominal hemorrhage secondary to liver and kidney injury is a major cause of morbidity and mortality. Endovascular arterial embolization is an established interventional radiology technique used to treat active bleeding, and its role in managing abdominal hemorrhages is growing, given the increasing trend for conservative treatment. Our study aims to retrospectively evaluate the technical and clinical results and the possible complications of arterial embolization procedures performed in emergency, in post-traumatic, iatrogenic, and pathological hepatic and renal bleedings. Methods: We performed a ten-year, single-center retrospective survey (from January 2010 to December 2019) of all patients treated in emergency by intra-arterial embolization of liver and kidney bleeding. Preliminary CT angiography studies were evaluated, as well as the angiographic findings. Materials used, procedural data, and clinical outcomes, including complications, were recorded. Results: The diagnostic angiography showed a single source of bleeding in 20 cases (66.7%), two bleeding vessels in 4 cases (13.3%), and multiple hemorrhagic sources in 6 cases (20%). All bleeding sources were successfully embolized; in 12 patients (40%), complete embolization was achieved with coils and 18 patients (60%) with hemostatic sponges. In one case, a second embolization procedure was performed for the persistence of hemodynamic instability. No major post-procedural complications were recorded. The mean procedure duration was 65.1 minutes. Conclusions: Based on our experience and literature data, the treatment of endovascular embolization in acute abdominal bleeding of hepatic and renal origin represents the treatment of choice, as it can provide complete therapeutic success in hemodynamically stable patients. (www.actabiomedica.it)
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Affiliation(s)
- Ferruccio Sgalambro
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy.
| | - Aldo Victor Giordano
- Interventional Radiology and Neuroradiology, San Salvatore Hospital, L'Aquila, Italy.
| | - Sergio Carducci
- Interventional Radiology and Neuroradiology, San Salvatore Hospital, L'Aquila, Italy.
| | - Marco Varrassi
- Interventional Radiology and Neuroradiology, San Salvatore Hospital, L'Aquila, Italy.
| | - Marco Perri
- Diagnostic and Interventional Radiology, SS. Filippo e Nicola Hospital, Avezzano (AQ), Italy.
| | - Francesco Arrigoni
- Department of Emergency and Interventional Radiology, San Salvatore Hospital, L'Aquila, Italy.
| | - Pierpaolo Palumbo
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy and Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy .
| | - Federico Bruno
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy and Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy.
| | - Luca Bardi
- Dipartimento di Scienze Biomediche Avanzate, Università Federico II, Napoli .
| | | | - Ginevra Danti
- Azienda Ospedaliero Universitaria Careggi, Firenze, Italy.
| | - Francesco Gentili
- Section of Radiology, Unit of Surgical Sciences, University of Parma, Parma, Italy.
| | - Maria Antonietta Mazzei
- Department of Medical, Surgical and Neuro Sciences, University of Siena, Department of Radiological Sciences, Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, Siena, Italy .
| | - Ernesto Di Cesare
- Department of Life, Health and Enviromental Sciences, University of L'Aquila, Italy.
| | - Alessandra Splendiani
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy.
| | - Carlo Masciocchi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy.
| | - Antonio Barile
- Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy.
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