Transcatheter Arterial Embolization (TAE) in the Management of Bleeding in the COVID-19 Patient
Roberto Minici,
Federico Fontana,
Massimo Venturini,
Giuseppe Guzzardi,
Agostino Siciliano,
Filippo Piacentino,
Raffaele Serra,
Andrea Coppola,
Pasquale Guerriero,
Biagio Apollonio,
Rita Santoro,
MGJR Research Team,
Luca Brunese,
Domenico Laganà
Affiliations
Roberto Minici
Radiology Unit, Dulbecco University Hospital, 88100 Catanzaro, Italy
Federico Fontana
Diagnostic and Interventional Radiology Unit, ASST Settelaghi, Insubria University, 21100 Varese, Italy
Massimo Venturini
Diagnostic and Interventional Radiology Unit, ASST Settelaghi, Insubria University, 21100 Varese, Italy
Giuseppe Guzzardi
Radiology Unit, Maggiore della Carità University Hospital, 28100 Novara, Italy
Agostino Siciliano
Radiology Unit, Dulbecco University Hospital, 88100 Catanzaro, Italy
Filippo Piacentino
Diagnostic and Interventional Radiology Unit, ASST Settelaghi, Insubria University, 21100 Varese, Italy
Raffaele Serra
Vascular Surgery Unit, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Dulbecco University Hospital, 88100 Catanzaro, Italy
Andrea Coppola
Diagnostic and Interventional Radiology Unit, ASST Settelaghi, Insubria University, 21100 Varese, Italy
Pasquale Guerriero
Radiology Unit, Santobono-Pausilipon Hospital, 80129 Naples, Italy
Biagio Apollonio
Radiology Unit, San Timoteo Hospital, 86039 Termoli, Italy
Rita Santoro
Haemophilia and Thrombosis Center, Dulbecco University Hospital, 88100 Catanzaro, Italy
MGJR Research Team
Magna Graecia Junior Radiologists Research Team, 88100 Catanzaro, Italy
Luca Brunese
Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy
Domenico Laganà
Radiology Unit, Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Dulbecco University Hospital, 88100 Catanzaro, Italy
Background and Objectives: Increasing attention is being paid to the coagulation disorders associated with SARS-CoV-2 infection. Bleeding accounts for 3–6% of COVID-19 patient deaths, and is often a forgotten part of the disease. The bleeding risk is enhanced by several factors, including spontaneous heparin-induced thrombocytopenia, thrombocytopenia, the hyperfibrinolytic state, the consumption of coagulation factors, and thromboprophylaxis with anticoagulants. This study aims to assess the efficacy and safety of TAE in the management of bleeding in COVID-19 patients. Materials and Methods: This multicenter retrospective study analyzes data from COVID-19 patients subjected to transcatheter arterial embolization for the management of bleeding from February 2020 to January 2023. Results: Transcatheter arterial embolization was performed in 73 COVID-19 patients for acute non-neurovascular bleeding during the study interval (February 2020–January 2023). Coagulopathy was observed in forty-four (60.3%) patients. The primary cause of bleeding was spontaneous soft tissue hematoma (63%). A 100% technical success rate was recorded; six cases of rebleeding resulted in a 91.8% clinical success rate. No cases of non-target embolization were observed. Complications were recorded in 13 (17.8%) patients. The efficacy and safety endpoints did not differ significantly between the coagulopathy and non-coagulopathy groups. Conclusions: Transcatheter Arterial Embolization (TAE) is an effective, safe and potentially life-saving option for the management of acute non-neurovascular bleeding in COVID-19 patients. This approach is effective and safe even in the subgroup of COVID-19 patients with coagulopathy.
