Role of percutaneous transcatheter embolization (PTE) in the treatment of spontaneous bleeding associated with anticoagulant therapy.
OBJECTIVE
To evaluate safety and clinical efficacy of percutaneous transcatheter embolization (PTE) in the treatment of spontaneous bleedings (SBs) in patients submitted to chronic anticoagulation therapy.


METHODS
From January 2007 to December 2012, 20 patients (mean age 75.8 years, range 68-91 years) with 23 SBs were retrospectively evaluated. Active bleeding was documented by contrast enhanced-multidetector row computed tomography (CE-MDCT). PTE was performed using different embolic agents. Technical success (TS), clinical success (CS), late success (LS) and mortality rate (M) related to the angiographic procedure and complications were evaluated.


RESULTS
CE-MDCT and digital subtraction angiography (DSA) identified active bleeding sites in 18 cases (18/20). In two cases (2/20) DSA did not confirm the arterial bleeding diagnosed on CE-MDCT. Twenty-three sessions of PTE were performed. TS, CS, LS and M were, respectively, 100, 85, 15 and 0%. No major complications were observed.


CONCLUSIONS
PTE could be considered a safe and effective "first line" approach to treat SB associated with anticoagulation therapy.
Interventional Radiology-Department of Radiology, University of Insubria, Viale Borri 57, 21100, Varese, Italy.
Anna Maria
AM
Ierardi
Chiara
C
Floridi
Carlo
C
Pellegrino
Mario
M
Petrillo
Antonio
A
Pinto
Isabella
I
Iadevito
Erica
E
Golia
Alessandra
A
Perillo
Roberto
R
Grassi
Antonio
A
Rotondo
Gianpaolo
G
Carrafiello
D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D000925:Anticoagulants / Q000009:adverse effects*; D003287:Contrast Media; D004621:Embolization, Therapeutic / Q000379:methods*; D017984:Enoxaparin / Q000009:adverse effects; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced* / Q000628:therapy*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014859:Warfarin / Q000009:adverse effects
D000925:Anticoagulants; D003287:Contrast Media; D017984:Enoxaparin; D014859:Warfarin