Cross‑sectional study of retroperitoneal hematoma after invasive intervention in a Chinese population: Prevalence, characteristics, management and outcomes

Abstract

The present study aimed to explore the clinical characteristics and management of retroperitoneal hematoma (RPH) after invasive intervention during a 12-year period in China. A retrospective review of patients with RPH after various invasive interventions was conducted at the China National Center for Cardiovascular Diseases. A total of 42 patients with a mean age of 63.1±2.5 years were continuously recruited in the study between January 2007 and September 2018. The incidence, manifestations and management of RPH were analyzed. A total of 20 patients had punctures in the femoral arterial access under the inguinal ligament and 5 patients had punctures above the inguinal ligament. The majority of RPH occurred within 24 h after intervention, while some occurred after postoperative 24 h. Pain was the most common symptom in patients with RPH. All patients who underwent intervention presented a reduction in hemoglobin (HB) concentration. The overall incidence of nosocomial infection was 38.1% and mortality was 7.1%. The findings demonstrated that RPH is a rare complication after invasive intervention of cardiovascular diseases with non-specific clinical manifestations. The reduction of HB concentration was a vital manifestation for RPH. Most RPH cases could be treated by conservative treatment and blood transfusion. A puncture in the femoral arterial access under the inguinal ligament may result in RPH.

Management of Acute Complications during Endovascular Procedures in Peripheral Arterial Disease: A Review

“…2 hypertension. [3][4][5][6][7] The recommended site for the common femoral artery (CFA) access is over the lower third of the femoral head below the inguinal ligament. Access above the pubic ramus is associated with a high probability of retroperitoneal bleeding due to lack of bony support for compression.…”

“…1 Risk factors for significant hematoma include older age, female gender, obesity, larger arterial sheath(> 8F), longer sheath dwell time, a higher dose of anticoagulants, high arterial puncture (above the inguinal ligament), and severe hypertension. 3 4 5 6 7 The recommended site for the common femoral artery (CFA) access is over the lower third of the femoral head below the inguinal ligament. Access above the pubic ramus is associated with a high probability of retroperitoneal bleeding due to lack of bony support for compression.…”