INTRODUCTION: Severe spontaneous bleeding is a significant complication in patients with continuous flow left ventricular assist devices; there is little evidence on endovascular treatment to support its use.MATERIALS AND METHODS: We observed seven patients (five men, two women, age 43-67years) with continuous flow left ventricular assist devices on antiaggregant/coagulant therapy, admitted to our hospital for uncorrectable symptomatic anemia; CT-angiography and diagnostic angiography confirmed the presence of atraumatic arterious bleeding from the gastrointestinal tract (six patients), from the intercostal artery and from the bronchial tree (one patient).RESULTS: All patients where successfully treated via an endovascular approach with superselective embolization of the involved arterial branches with coils and particles.CONCLUSION: Spontaneous atraumatic bleeding is a frequent complication in patients with continuous flow left ventricular assist devices; endovascular treatment represents a promising alternative to the surgical approach as it is less invasive, easily repeatable and associated to a reduced procedural risk.

Outcomes of patients with continuous flow left ventricular assist device undergoing emergency endovascular treatment for atraumatic bleeding

Bernardinello, Valentina;Barbiero, Giulio;Battistel, Michele;Dengo, Caterina;Stramare, Roberto;Folino, Giulio;Bejko, Jonida;Carrozzini, Massimiliano;Gerosa, Gino;Bottio, Tomaso
2019

Abstract

INTRODUCTION: Severe spontaneous bleeding is a significant complication in patients with continuous flow left ventricular assist devices; there is little evidence on endovascular treatment to support its use.MATERIALS AND METHODS: We observed seven patients (five men, two women, age 43-67years) with continuous flow left ventricular assist devices on antiaggregant/coagulant therapy, admitted to our hospital for uncorrectable symptomatic anemia; CT-angiography and diagnostic angiography confirmed the presence of atraumatic arterious bleeding from the gastrointestinal tract (six patients), from the intercostal artery and from the bronchial tree (one patient).RESULTS: All patients where successfully treated via an endovascular approach with superselective embolization of the involved arterial branches with coils and particles.CONCLUSION: Spontaneous atraumatic bleeding is a frequent complication in patients with continuous flow left ventricular assist devices; endovascular treatment represents a promising alternative to the surgical approach as it is less invasive, easily repeatable and associated to a reduced procedural risk.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11577/3357239
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