The purpose of this study was to report a single hospital's experience of endovascular treatment of patients with retroperitoneal hemorrhage (RPH) secondary to anticoagulant treatment. Ten consecutive patients treated in an intensive care unit and needing blood transfusions due to RPH secondary to anticoagulation were referred for digital subtraction angiography (DSA) to detect the bleeding site(s) and to evaluate the possibilities of treating them by transcatheter embolization. DSA revealed bleeding site(s) in all 10 patients: 1 lumbar artery in 4 patients, 1 branch of internal iliac artery in 3 patients and multiple bleeding sites in 3 patients. Embolization could be performed in 9 of them. Coils, gelatin and/or polyvinyl alcohol were used as embolic agents. Bleeding stopped or markedly decreased after embolization in 8 of the 9 (89%) patients. Four patients were operated on prior to embolization, but surgery failed to control the bleeding in any of these cases. Abdominal compartment syndrome requiring surgical or radiological intervention after embolization developed in 5 patients. One patient died, and 2 had sequelae due to RPH. All 7 patients whose bleeding stopped after embolization had a good clinical outcome. Embolization seems to be an effective and safe method to control the bleeding in patients with RPH secondary to anticoagulant treatment when conservative treatment is insufficient.
BACKGROUND AND PURPOSE:Peripheral aneurysms of the posterior inferior cerebellar artery (PICA) are rare, and pre-existing literature concerning their endovascular treatment is limited. The purpose of this study was to assess the etiology and clinical characteristics of peripheral PICA aneurysms and to evaluate the angiographic and clinical results of the patients who underwent endovascular treatment for a peripheral PICA aneurysm in a single center.
BACKGROUND AND PURPOSE:While the number of CTA examinations is continually increasing compared with DSA examinations, there is little comparative dose information about the different imaging techniques. We compared patient radiation exposure resulting from diagnostic CTA and DSA examinations for both cerebral and cervicocerebral vessels.
The incidence of early rebleeding after acutely coiled ruptured IA was 3.6%. Risk factors for post-procedural rehemorrhage were the presence of ICH on the initial CT and HH grade 3–5 before coiling. Early rebleeding appeared exclusively as an enlargement of the initial ICH and not an increased amount of blood in the subarachnoid space.
The treatment method used for acutely ruptured intracranial aneurysms, i.e., neurosurgical clipping or endovascular coiling, has no statistically significant effect on the development of chronic hydrocephalus.
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