Table 2.
Nonsurgical treatments and outcomes
| Selective?a | Angiographic management n (%) | No intervention n (%) | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TAE | Stent | Failures | Rebleed | Secondary treatment | Death | Indication | Death | ||||||||
| A | B | C | D | E | F | G | N | ||||||||
| n | n (% A) | n (% A) | Vessel stented | n (% B + C) | n (% B + C) | Emb | Sten | Sur | No | n (% B + C) | n (% A) | n (% N) | |||
| Postoperative only | |||||||||||||||
| Okuno et al. [13] | 14 | – | 12 (86) | 0 (0) | 2 (17)b | 1 | 1 | 3 (25) | 1 (7)c | SMA | 0 (0) | ||||
| Fujii et al. [12] | 13 | – | 9 (69) | 0 (0) | 4 (44)b | 2 | 2 | 4 (44) | 1 (8) | Occlusion CHAd | 1 (100) | ||||
| Miura et al. [5] | 15 | – | 12 (80) | 0 (0) | 1 (8) | 1 (8) | 1 | 1 | 6 (50) | 0 (0) | |||||
| Lee [15] | 27 | – | 22 (81) | 1 (4) | SMA | 5 (22) | 4 (17) | 4 | 5 | 3 (13) | 2 (7) | Death | 2 (100) | ||
| Schäfer et al. [30] | 18 | – | 9 (50) | 3 (17)f | – | 2 (17) | 3 (25)g | 3 | 1 | 1 | 2 (17) | 0 (0) | |||
| Lee et al. [31] | 27 | – | 22 (81) | 4 (15) | – | 1 (4) | 0 (0) | 3e | 5 (19) | 0 (0) | |||||
| Pancreatitis only | |||||||||||||||
| Gambiez et al. [37] | 14 | – | 14 (100) | 0 (0) | 3 (21) | 0 (0) | 3 | 2 (14) | 0 (0) | ||||||
| De Perrot et al . [14] | 10 | – | 3 (30) | 0 (0) | 0 (0) | 1 (33) | 1 | 1 (33) | 0 (0) | ||||||
| Carr et al. [38] | 16 | – | 6 (38) | 0 (0) | 3 (50) | 0 (0) | 3 | 0 (0) | 0 (0) | ||||||
| Beattie et al. [23] | 13 | – | 8 (62) | 0 (0) | 0 (0) | 3 (38) | 1 | 1 | 1 | 1(13) | 2 (15) | Unknown | 0 (0) | ||
| Bergert et al. [11] | 35 | – | 16 (46) | 0 (0) | 0 (0) | 2 (13) | 2 | 3 (19) | 0 (0) | ||||||
| Zhou et al. [40] | 19 | T | 19 (100) | 0 (0) | 2 (11) | 7 (37) | 2 | 5 (26) | 0 (0) | ||||||
| Lermite et al. [16] | 17 | – | 8 (53) | 0 (0) | 2 (22) | 3 (33) | 3 | 2 | 0 (0) | 1 (6) | Angio –ve | 0 (0) | |||
| Udd et al. [25] | 33 | A | 23 (70) | 0 (0) | 4 (17)b | 4 | 1 (4) | 0 (0) | |||||||
| Sethi et al. [27] | 16 | – | 13 (82) | 0 (0) | 3 (23) | 0 (0)h | 3 | 0 (0) | 1 (6) | Spont thrombi | 0 (0) | ||||
| Both pancreatitis and postoperative | |||||||||||||||
| Zyromski et al. [3] | 37 | – | 34 (92) | 1 (3) | – | 0 (0) | 2 (6) | 2 | 4 (11) | 1 (3) | Unknown | – | |||
| Kalva et al. [1] | 23 | A | 23 (100) | 0 (0) | 1 (4) | 4 (17) | 2 | 1 | 2 | 6 (26) | 0 (0) | ||||
A/Angio angiogram, CHA common hepatic artery, Emb embolisation, No no interventional treatment, Sten vascular stent insertion, Surg surgical management, SMA superior mesenteric artery, Spont thromb spontaneous thrombosis, T trans-arterial embolisation
aSelective group by intervention: T TAE, A angiogram, – not selected on basis of intervention
bUnclear whether it is primary failure or recurrent bleeding after initial haemostasis
cIntra-arterial vasopressin infusion for SMA bleed (TAE not performed for fear of ischaemia)
dIntimal injury to CHA during angiography → occlusion and control of PHA extravasation
eThree patients required secondary procedure for abdominal compartment syndrome. The one patient with failed embolisation sustained a CHA dissection, which actually controlled the bleeding due to reduced intrahepatic arterial flow
fThese three patients also had coiling performed
gThe number of failures/rebleeding and the subsequent intervention is unclear from the paper
hThree patients with continued filling of the pseudoaneurysm on CT. These were embolised successfully
iSpontaneous thrombosis of a gastroduodenal pseudoaneurysm