Role of Intercostal Artery Embolization in Management of Traumatic Hemothorax

Lohan, Rahul; Leow, Kheng Song; Ong, Marc Weijie; Goo, Tiong Thye; Punamiya, Sundeep

doi:10.4103/jets.jets_157_20

Cited by 5 publications

(6 citation statements)

References 17 publications

(20 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Transarterial embolization is known to be a highly efficient therapy to stop the postoperative bleeding definitively. 6 In this study, transarterial embolization was mainly performed as a rescue strategy when uncontrollable bleeding with an arterial blush on contrast enhanced computed tomography (CT) scan was present. We believe this endovascular technique should be readily available in hospitals taking care of ECMO patients.…”

Section: Discussionmentioning

confidence: 99%

Video-assisted thoracic surgery in critically ill COVID-19 patients on venovenous extracorporeal membrane oxygenation

et al. 2022

View full text Add to dashboard Cite

Introduction Coronavirus disease 2019 (COVID-19) leads to thoracic complications requiring surgery. This is challenging, particularly in patients supported with venovenous extracorporeal membrane oxygenation (VV-ECMO) due to the need for continuous therapeutic anticoagulation. We aim to share our experience regarding the safety and perioperative management of video-assisted thoracic surgery for this specific population. Methods Retrospective, single-center study between November 2020 and January 2022 at the ICU department of a 1.061-bed tertiary care and VV-ECMO referral center during the COVID-19 pandemic. Results 48 COVID-19 patients were supported with VV-ECMO. A total of 14 video-assisted thoracic surgery (VATS) procedures were performed in seven patients. Indications were mostly hemothorax (85.7%). In eight procedures heparin was stopped at least 1 h before incision. A total of 10 circuit changes due to clot formation or oxygen transfer failure were required in six patients (85.7%). One circuit replacement seemed related to the preceding VATS procedure, although polytransfusion might be a contributing factor. None of the mechanical complications was fatal. Four VATS-patients (57.1%) died, of which two (50%) immediately perioperatively due to uncontrollable bleeding. All three survivors were treated with additional transarterial embolization. Conclusion (1) Thoracic complications in COVID-19 patients on VV-ECMO are common. (2) Indication for VATS is mostly hemothorax (3) Perioperative mortality is high, mostly due to uncontrollable bleeding. (4) Preoperative withdrawal of anticoagulation is not directly related to a higher rate of ECMO circuit-related complications, but a prolonged duration of VV-ECMO support and polytransfusion might be. (5) Additional transarterial embolization to control postoperative bleeding may further improve outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Video-assisted thoracic surgery in critically ill COVID-19 patients on venovenous extracorporeal membrane oxygenation

et al. 2022

View full text Add to dashboard Cite

show abstract

“…In the event of persistent bleeding from posterior intercostal arteries, haemostasis may be difficult to achieve due to limited exposure at the posterior ribs space. Transarterial embolisation remains the endovascular therapeutic option of choice to control such intrathoracic haemorrhage [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Haemothorax in a Patient with COVID-19

Mohan

Sufyaan

Hashim

2022

Case Reports in Medicine

View full text Add to dashboard Cite

The global pandemic of COVID-19 is caused by SARS-CoV-2 virus. We continue to discover the wide spectrum of complications associated with COVID-19. Some well-known complications include pneumonia, acute respiratory distress syndrome, pneumothorax, disseminated intravascular coagulation (DIC), chronic fatigue, multiorgan dysfunction, and long COVID-19 syndrome. We report a rare case of a 51-year-old man with severe COVID-19 pneumonia who developed haemorrhagic shock secondary to spontaneous haemothorax after 17 days of hospitalisation. Clinicians should be aware of such occurrence, and hence, high clinical suspicion, prompt recognition of signs and symptoms of shock, and adequate resuscitation will improve the outcomes of patients.

show abstract

“…Although most literature on angiographic coil embolization is based on trauma-related ICA injury, several case reports suggest it is safe and effective in spontaneous ICA bleeding. 7 , 8 , 9 The seemingly best management strategy for spontaneous rupture of the ICA appears to be a combination of coil embolization and surgical repair. 1 , 8 …”

Section: Discussionmentioning

confidence: 99%

Role of Intercostal Artery Embolization in Management of Traumatic Hemothorax

Cited by 5 publications

References 17 publications

Video-assisted thoracic surgery in critically ill COVID-19 patients on venovenous extracorporeal membrane oxygenation

Video-assisted thoracic surgery in critically ill COVID-19 patients on venovenous extracorporeal membrane oxygenation

Spontaneous Haemothorax in a Patient with COVID-19

Fatal Spontaneous Intercostal Artery Bleeding During Catheter Ablation for Atrial Fibrillation

Contact Info

Product

Resources

About