Post-pancreaticoduodenectomy hemorrhage: DSA diagnosis and endovascular treatment

Oncotarget
Tanyang ZhouShusen Zheng

Abstract

To explore the diagnostic value of digital subtraction angiography (DSA) and the effectiveness of endovascular treatment for a post-pancreaticoduodenectomy hemorrhage (PPH). During the DSA examination, positive results were found in 29 patients, yielding a positive rate of 69.0%. The manifestations of the DSA examination included contrast medium extravasation, pseudoaneurysm, and artery walls coarse. All 29 patients with positive results underwent endovascular treatment, including transartery embolization (TAE) in 28 patients and covered stents placement in one patient. The technical success and clinical success rates were 100% and 72.4%, respectively. Re-bleeding occurred in 8 of the 29 patients after the first treatment (27.6%). The mortality of PPH was 17.2% (5 of 29). Two of the five PPH patients died following severe infections, and three died from multiple organ failure. A DSA examination was conducted using clinical and imaging data of 42 patients, and endovascular treatment for delayed PPH was retrospectively analyzed. DSA examination is a minimally invasive and rapid method for the diagnosis of delayed PPH. For patients with positive DSA results, endovascular treatment can be performed rapidly, safely, and effectively....Continue Reading

References

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Citations

Sep 28, 2017·Abdominal Radiology·Annabelle L Fonseca, Jason B Fleming
Jul 8, 2018·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Alban Zarzavadjian Le BianDavid Fuks
Jan 16, 2020·Journal of Cancer Research and Therapeutics·Hua QiuJun Shi

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Methods Mentioned

BETA
dissection
SMA

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