Background: critically ill patients with SARS-CoV-2 infection present a hypercoagulable condition. Anticoagulant therapy is currently recommended to reduce thrombotic risk, leading to potentially severe complications like spontaneous bleeding (SB). Percutaneous transcatheter arterial embolization (PTAE) can be life-saving in critical patients, in addition to medical therapy. We report a major COVID-19 Italian Research Hospital experience during the pandemic, with particular focus on indications and technique of embolization. Methods: We retrospectively included all subjects with SB and with a microbiologically confirmed SARS-CoV-2 infection, over one year of pandemic, selecting two different groups: (a) patients treated with PTAE and medical therapy; (b) patients treated only with medical therapy. Computed tomography (CT) scan findings, clinical conditions, and biological findings were collected. Results: 21/1075 patients presented soft tissue SB with an incidence of 1.95%. 10/21 patients were treated with PTAE and medical therapy with a 30-days survival of 70%. Arterial blush, contrast late enhancement, and dimensions at CT scan were found discriminating for the embolization ( p < 0.05). Conclusions: PTAE is an important tool in severely ill, bleeding COVID-19 patients. The decision for PTAE of COVID-19 patients must be carefully weighted with particular attention paid to the clinical and biological condition, hematoma location and volume.
【저자키워드】 COVID-19, Low-molecular-weight heparin, spontaneous bleeding, percutaneous trans arterial embolization, 【초록키워드】 pandemic, therapy, SARS-COV-2 infection, tomography, survival, CT scan, Patient, bleeding, incidence, Critical, patients, COVID-19 patients, COVID-19 patient, hematoma, hypercoagulable, Critically ill patient, Volume, tissue, indication, clinical conditions, dimension, thrombotic risk, arterial, Percutaneous, Italian, collected, addition, treated, reduce, severe complication, all subject, microbiologically, patients treated, 【제목키워드】 embolization, Spontaneous,