Selected article for: "CT scan and risk reduce"

Author: Riu, Pascale; Albarello, Fabrizio; Di Stefano, Federica; Vergori, Alessandra; D’Abramo, Alessandra; Cerini, Carlo; Nocioni, Martina; Morucci, Maurizio; Tetaj, Nardi; Cristofaro, Massimo; Schininà, Vincenzo; Campioni, Paolo; Petrone, Ada; Fusco, Nicoletta; Marchioni, Luisa; Antinori, Andrea; Nicastri, Emanuele; Cianni, Roberto; Ianniello, Stefania
Title: Management of Spontaneous Bleeding in COVID-19 Inpatients: Is Embolization Always Needed?
  • Cord-id: uz4a9y5t
  • Document date: 2021_9_12
  • ID: uz4a9y5t
    Snippet: Background: critically ill patients with SARS-CoV-2 infection present a hypercoagulable condition. Anticoagulant therapy is currently recommended to reduce thrombotic risk, leading to potentially severe complications like spontaneous bleeding (SB). Percutaneous transcatheter arterial embolization (PTAE) can be life-saving in critical patients, in addition to medical therapy. We report a major COVID-19 Italian Research Hospital experience during the pandemic, with particular focus on indications
    Document: Background: critically ill patients with SARS-CoV-2 infection present a hypercoagulable condition. Anticoagulant therapy is currently recommended to reduce thrombotic risk, leading to potentially severe complications like spontaneous bleeding (SB). Percutaneous transcatheter arterial embolization (PTAE) can be life-saving in critical patients, in addition to medical therapy. We report a major COVID-19 Italian Research Hospital experience during the pandemic, with particular focus on indications and technique of embolization. Methods: We retrospectively included all subjects with SB and with a microbiologically confirmed SARS-CoV-2 infection, over one year of pandemic, selecting two different groups: (a) patients treated with PTAE and medical therapy; (b) patients treated only with medical therapy. Computed tomography (CT) scan findings, clinical conditions, and biological findings were collected. Results: 21/1075 patients presented soft tissue SB with an incidence of 1.95%. 10/21 patients were treated with PTAE and medical therapy with a 30-days survival of 70%. Arterial blush, contrast late enhancement, and dimensions at CT scan were found discriminating for the embolization (p < 0.05). Conclusions: PTAE is an important tool in severely ill, bleeding COVID-19 patients. The decision for PTAE of COVID-19 patients must be carefully weighted with particular attention paid to the clinical and biological condition, hematoma location and volume.

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