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Endovascular Management of Hemarthrosis in Patients with Bleeding Diatheses: Systematic Review.
CardioVascular and Interventional Radiology ( IF 2.8 ) Pub Date : 2019-11-05 , DOI: 10.1007/s00270-019-02367-7
Srinidhi Shanmugasundaram 1 , Vishnu Chandra 1 , Marcin Kolber 2 , Abhishek Kumar 1 , Sohail Contractor 1 , Pratik A Shukla 1
Affiliation  

PURPOSE In this systematic review, we report the safety and efficacy of embolization for treating hemarthrosis in patients with bleeding diatheses with or without a history of prior arthroplasty. MATERIALS AND METHODS A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. A structured search was performed in PubMed, Web of Science, MEDLINE, and SCOPUS databases of patients undergoing embolization for hemarthrosis. Demographic data, clinical history, angiographic findings, interventions, and outcomes were extracted and tabulated. RESULTS The search identified 97 unique titles of which 15 were deemed relevant comprising 78 patients with coagulopathies undergoing 93 embolization procedures. Mean follow-up time was 29 months (range 3-116.5). In the 29 patients who underwent arthroplasty prior to embolization for hemarthrosis, there were 11 bleeding recurrences (37.9%). Of these patients who experienced recurrences, 10 underwent repeat embolization as coagulation factor replacement was not sufficient to address the re-bleeding. In the 49 patients with bleeding diatheses who underwent embolization for hemarthrosis with no history of prior arthroplasty, there were 11 recurrences (22.4%) and 4 of these patients underwent repeat embolization with favorable results. There were four major procedure-related complications. CONCLUSION Transarterial embolization is safe and effective in addressing recurrent hemarthrosis in patients with bleeding diatheses with or without a history of arthroplasty of the affected joint.

中文翻译:

出血性糖尿病患者的血管内血管管理:系统评价。

目的在本系统评价中,我们报告了栓塞术在有或没有既往关节置换术史的出血性血液透析患者中​​治疗血栓形成的安全性和有效性。材料和方法根据系统评价和荟萃分析的首选报告项目进行了系统评价。在PubMed,Web of Science,MEDLINE和SCOPUS数据库中进行了针对栓塞性血栓形成的患者的结构化搜索。提取人口统计数据,临床病史,血管造影发现,干预措施和结果,并制成表格。结果该搜索确定了97个独特的标题,其中15个被认为相关,包括78个接受93次栓塞手术的凝血病患者。平均随访时间为29个月(范围3-116.5)。在栓塞术前因血栓形成而接受了关节置换术的29例患者中,有11例复发(37.9%)。在这些复发的患者中,有10人进行了重复栓塞术,因为凝血因子替代治疗不足以解决再出血。在49例因出血而接受栓塞治疗的出血患者中,既往无人工关节置换史,其中11例复发(22.4%),其中4例患者进行了重复栓塞术,效果良好。有四个与手术相关的主要并发症。结论经动脉栓塞术对于有或没有受累关节置换术史的出血性出血患者,可安全有效地治疗复发性血栓形成。有11例出血复发(37.9%)。在这些复发的患者中,有10人进行了重复栓塞术,因为凝血因子替代治疗不足以解决再出血。在49例因出血而接受栓塞治疗的出血患者中,既往无人工关节置换史,其中11例复发(22.4%),其中4例患者进行了重复栓塞术,效果良好。有四个与手术相关的主要并发症。结论经动脉栓塞术对于有或没有受累关节置换术史的出血性出血患者,可安全有效地治疗复发性血栓形成。有11例出血复发(37.9%)。在这些复发的患者中,有10人进行了重复栓塞术,因为凝血因子替代治疗不足以解决再出血。在49例因出血而接受栓塞治疗的出血患者中,既往无人工关节置换史,其中11例复发(22.4%),其中4例患者进行了重复栓塞术,效果良好。有四个与手术相关的主要并发症。结论经动脉栓塞术对于有或没有受累关节置换术史的出血性出血患者,可安全有效地治疗复发性血栓形成。由于凝血因子替代不足以解决再出血,对10进行了重复栓塞。在49例因出血而接受栓塞治疗的出血患者中,既往无人工关节置换史,其中11例复发(22.4%),其中4例患者进行了重复栓塞术,效果良好。有四个与手术相关的主要并发症。结论经动脉栓塞术对于有或没有受累关节置换术史的出血性出血患者,可安全有效地治疗复发性血栓形成。由于凝血因子替代不足以解决再出血,对10进行了重复栓塞。在49例因出血而接受栓塞治疗的出血患者中,既往无人工关节置换史,其中11例复发(22.4%),其中4例患者进行了重复栓塞术,效果良好。有四个与手术相关的主要并发症。结论经动脉栓塞术对于有或没有受累关节置换术史的出血性出血患者,可安全有效地治疗复发性血栓形成。这些患者中有4%进行了重复栓塞治疗,其中4例得到了满意的结果。有四个与手术相关的主要并发症。结论经动脉栓塞术对于有或没有受累关节置换术史的出血性出血患者,可安全有效地治疗复发性血栓形成。4%的患者)中有4例进行了重复栓塞术,效果良好。有四个与手术相关的主要并发症。结论经动脉栓塞术对于有或没有受累关节置换术史的出血性出血患者,可安全有效地治疗复发性血栓形成。
更新日期:2020-02-04
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