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J. Clin. Med. 2017, 6(4), 47; doi:10.3390/jcm6040047

Predictors of Active Extravasation and Complications after Conventional Angiography for Acute Intraabdominal Bleeding

1
School of Medicine, New York University, 550 1st Avenue, New York, NY 10016, USA
2
South Florida Vascular Associates, Coconut Creek, FL 33073, USA
3
Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Bernhard Rauch
Received: 15 March 2017 / Revised: 13 April 2017 / Accepted: 14 April 2017 / Published: 18 April 2017
View Full-Text   |   Download PDF [215 KB, uploaded 18 April 2017]

Abstract

Conventional angiography is used to evaluate and treat possible sources of intraabdominal bleeding, though it may cause complications such as contrast-induced nephropathy (CIN). The study’s purpose was to identify factors predicting active extravasation and complications during angiography for acute intraabdominal bleeding. All conventional angiograms for acute bleeding (January 2013–June 2015) were reviewed retrospectively, including 75 angiograms for intraabdominal bleeding in 70 patients. Demographics, comorbidities, vital signs, complications within one month, and change in hematocrit (ΔHct) and fluids and blood products administered over the 24 h prior to angiography were recorded. Of 75 exams, 20 (27%) demonstrated extravasation. ΔHct was the only independent predictor of extravasation (p = 0.017), with larger ΔHct (−17%) in patients with versus those without extravasation (–1%) (p = 0.01). CIN was the most common complication, occurring in 10 of 66 angiograms (15%). Glomerular filtration rate (GFR) was the only independent predictor (p = 0.03); 67% of patients with GFR < 30, 29% of patients with GFR 30–60, and 8% of patients with GFR > 60 developed CIN. For patients with intraabdominal bleeding, greater ΔHct decrease over 24 h before angiography predicts active extravasation. Pre-existing renal impairment predicts CIN. Patients with large hematocrit declines should be triaged for rapid angiography, though benefits can be weighed with the risk of renal impairment. View Full-Text
Keywords: hemorrhage; angiography; contrast-induced nephropathy; hematocrit; GFR hemorrhage; angiography; contrast-induced nephropathy; hematocrit; GFR
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Haber, Z.M.; Charles, H.W.; Erinjeri, J.P.; Deipolyi, A.R. Predictors of Active Extravasation and Complications after Conventional Angiography for Acute Intraabdominal Bleeding. J. Clin. Med. 2017, 6, 47.

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