Embolization of active arterial bleeding in COVID-19 patients: A multicenter study.

Autor: Steinberg HL; Institut für Diagnostische und Interventionelle Radiologie, Universitätsmedizin Essen, Germany. Electronic address: Hannah.Steinberg@uk-essen.de., Auer TA; Klinik für Radiologie, Charité Universitätsmedizin Berlin, Germany; Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Straße 2, 10178 Berlin, Germany., Gebauer B; Klinik für Radiologie, Charité Universitätsmedizin Berlin, Germany., Kloeckner R; Institut für Interventionelle Radiologie, Universitätsklinikum Schleswig-Holstein, Germany., Sieren M; Institut für Interventionelle Radiologie, Universitätsklinikum Schleswig-Holstein, Germany., Minko P; Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Düsseldorf, Germany., Jannusch K; Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Düsseldorf, Germany., Wildgruber M; Klinik und Poliklinik für Radiologie, LMU Klinikum München, Germany., Schmidt VF; Klinik und Poliklinik für Radiologie, LMU Klinikum München, Germany., Pinto Dos Santos D; Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Köln, Germany; Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Frankfurt, Germany., Dratsch T; Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Köln, Germany., Hinrichs JB; Institut für Diagnostische und Interventionelle Radiologie, Medizinische Hochschule Hannover, Germany., Torsello G; Institut für Diagnostische und Interventionelle Radiologie, Universitätsmedizin Göttingen, Germany., Stoehr F; Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsmedizin Mainz, Germany., Müller L; Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsmedizin Mainz, Germany., Herbstreit F; Klinik für Anästhesiologie und Intensivmedizin, Universitätsmedizin Essen, Germany., Forsting M; Institut für Diagnostische und Interventionelle Radiologie, Universitätsmedizin Essen, Germany., Schaarschmidt BM; Institut für Diagnostische und Interventionelle Radiologie, Universitätsmedizin Essen, Germany.
Jazyk: angličtina
Zdroj: European journal of radiology [Eur J Radiol] 2023 Aug; Vol. 165, pp. 110892. Date of Electronic Publication: 2023 May 26.
DOI: 10.1016/j.ejrad.2023.110892
Abstrakt: Purpose: The purpose of this study was to assess the efficacy of transarterial embolization in COVID-19 patients with an arterial bleeding and to investigate differences between various patient groups concerning survival.
Method: We retrospectively reviewed COVID-19 patients undergoing transarterial embolization due to an arterial bleeding in a multicenter study from April 2020 to July 2022 and analyzed the technical success of embolization and survival rate. 30-day survival between various patient groups was analyzed. The Chi- square test and Fisher's exact test were used for testing association between the categorical variables.
Results: 53 COVID-19 patients (age: 57.3 ± 14.3 years, 37 male) received 66 angiographies due to an arterial bleeding. The initial embolization was technically successful in 98.1% (52/53). In 20.8% (11/53) of patients, additional embolization was necessary due to a new arterial bleeding. A majority of 58.5% (31/53) had a severe course of COVID-19 infection necessitating ECMO-therapy and 86.8% (46/53) of patients received anticoagulation. 30-day survival rate in patients with ECMO-therapy was significantly lower than without ECMO-therapy (45.2% vs. 86.4%, p = 0.004). Patients with anticoagulation did not have a lower 30-day survival rate than without anticoagulation (58.7% vs. 85.7%, p = 0.23). COVID-19 patients with ECMO-therapy developed more frequently a re-bleeding after embolization than non-ECMO-patients (32.3% vs. 4.5%, p = 0.02).
Conclusions: Transarterial embolization is a feasible, safe, and effective procedure in COVID-19 patients with arterial bleeding. ECMO-patients have a lower 30-day survival rate than non-ECMO-patients and have an increased risk for re-bleeding. Treatment with anticoagulation could not be identified as a risk factor for higher mortality.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023. Published by Elsevier B.V.)
Databáze: MEDLINE
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