Spontaneous soft tissue hematomas - 07/08/15

Doi : 10.1016/j.diii.2015.03.014

A. Dohan ^d,^e,^f, L. Darnige ^g, M. Sapoval ^a,^b,^c, O. Pellerin ^a,^b,^c,^⁎
^a Université Paris Descartes, Sorbonne Paris Cité, Faculté de médecine, 15, rue de l’École de Médecine, 75006 Paris, France
^b INSERM U970, Faculté de médecine, Université Paris Descartes Sorbonne Paris Cité Assistance Public Hôpitaux de Paris, Hôpital Européen Georges Pompidou Vascular and Oncological Interventional Radiology Department, 20, rue Leblanc, 75015 Paris, France
^c Assistance publique–Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Vascular and Oncological Interventional Radiology Department, 20, rue Leblanc, 75015 Paris, France
^d Université Paris-Diderot, 10, rue de Verdun, 75010 Paris, France
^e Inserm U965, French National Institute for Health and Medical Research Unit 965, France
^f Assistance publique–Hôpitaux de Paris, Hôpital Lariboisière, Visceral and Vascular Radiology Department, 2, rue Ambroise-Paré, 75475 Paris, France
^g Faculté de médecine, Université Paris Descartes Sorbonne Paris Cité Assistance Public Hôpitaux de Paris, Hôpital Européen Georges Pompidou Hematology Department, 20, rue Leblanc, 75015 Paris, France

^⁎Corresponding author at: Vascular and Oncological Interventional Radiology Department, Georges-Pompidou European Hospital, 20, rue Leblanc, 75015 Paris, France.

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Abstract

Spontaneous muscle hematomas are a common and serious complication of anticoagulant treatment. The incidence of this event has increased along with the rise in the number of patients receiving anticoagulants. Radiological management is both diagnostic and interventional. Computed tomography angiography (CTA) is the main tool for the detection of hemorrhage to obtain a positive, topographic diagnosis and determine the severity. Detection of an active leak of contrast material during the arterial or venous phase is an indication for the use of arterial embolization. In addition, the interventional radiological procedure can be planned with CTA. Arterial embolization of the pedicles that are the source of the bleeding is an effective technique. The rate of technical and clinical success is 90% and 86%, respectively.

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Keywords : Embolization, Hematomas of soft tissue, Muscle hematomas, Angio-computed tomography

Abbreviations : CTA, SMH, IEA, SEA, CIA, LA, ILA, HAS

Plan

Background

Definition

Role of anticoagulants

Factors of severity

Physiopathology

Anatomy

Vascular arterial anatomy

Topographic anatomy

Diagnosis

Clinical symptoms

Radiological diagnosis

Therapeutic management

Management algorithm

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Vol 96 - N° 7-8

P. 789-796 - juillet 2015 Retour au numéro

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Spontaneous soft tissue hematomas - 07/08/15

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