Comparison of Bleeding Complications between Transplenic versus Transhepatic Access of the Portal Venous System
| Autor: | James C. Andrews, Mustafa M. Haddad, Chad J. Fleming, Christopher J. Reisenauer, Ahmad Parvinian, Scott M. Thompson, Gregory T. Frey, Beau Toskich |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Blood transfusion Computed Tomography Angiography medicine.medical_treatment Portal venous system Hemorrhage Punctures Radiography Interventional 030218 nuclear medicine & medical imaging Young Adult 03 medical and health sciences 0302 clinical medicine Risk Factors Angioplasty Catheterization Peripheral medicine Humans Radiology Nuclear Medicine and imaging Embolization Aged Retrospective Studies Aged 80 and over Portal Vein business.industry Endovascular Procedures Stent Retrospective cohort study Phlebography Middle Aged Embolization Therapeutic Surgery Treatment Outcome Splenic Vein Splenic vein Female Stents 030211 gastroenterology & hepatology Portasystemic Shunt Transjugular Intrahepatic Cardiology and Cardiovascular Medicine Varices business |
| Zdroj: | Journal of Vascular and Interventional Radiology. 29:1383-1391 |
| ISSN: | 1051-0443 |
| DOI: | 10.1016/j.jvir.2018.04.033 |
| Popis: | Purpose To evaluate the incidence of bleeding complications between transplenic (TS) and transhepatic (TH) access in portal venous interventions. Materials and Methods Retrospective review of patients who underwent TS or TH access for portal venous system interventions from January 2000 to August 2017. Only procedures with clinical and laboratory follow-up were included (n = 148). Twenty-four TS procedures were performed in 22 patients, and 124 TH procedures were performed in 114 patients. The main indications were for angioplasty/stent, embolization of varices/shunt, or portal vein embolization, with no difference between the groups. Mean patient age and sex were not significantly different between the groups ( P values .445 and .682, respectively). Mean follow up was 2.3 years (range 0.1–14.2). There was no significant difference between the international normalized ratio ( P = .300) and platelets ( P = .234) before the procedure between the 2 cohorts. Results Technical success of vascular access and procedural success was achieved in 22/24 (91.6%) TS procedures and 120/124 (96.8%) TH procedures ( P = .238). There was no significant difference in bleeding complications between the 2 groups (3/24 [12.5%] TS vs 10/124 [8.1%] TH; P = .44). There was no significant difference in major bleeding complications (SIR classification ≥ C; 1/24 [4.2%] TS vs 4/124 [3.2%] TH; P = .789).There was no significant difference in the hemoglobin before or after the procedure (g/dL), with average change −1.1 g/dL (range −3.4 to +1.0) in the TS group and 1.0 g/dL (range −4.5 to +1.9) in the TH group ( P = .540). Finally, there was no significant difference in proportion of patients requiring blood transfusion after the procedure ( P = .520), with 2 (8.3%) in the TS group requiring an average of 4 units (range 2–6) and 17 (13.7%) in the TH group requiring an average of 3.5 units (range 1–26). Conclusions These data suggest no significant difference in bleeding complications between TS and TH access for portal venous interventions. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|