TY  - BOOK
AU  - Ben-Dor, Itsik
AU  - Bernardo, Nelson L
AU  - Gaglia, Michael AJ
AU  - Maluenda, Gabriel
AU  - Mitulescu, Lavinia
AU  - Pichard, Augusto D
AU  - Satler, Lowell F
AU  - Torguson, Rebecca
AU  - Waksman, Ron
AU  - Weissman, Gaby
TI  - Retroperitoneal hemorrhage after percutaneous coronary intervention in the current practice era: clinical outcomes and prognostic value of abdominal/pelvic computed tomography
SN  - 1522-1946
KW  - *Angioplasty, Balloon, Coronary/ae [Adverse Effects]
KW  - *Hemorrhage/ra [Radiography]
KW  - *Hemorrhage/th [Therapy]
KW  - *Radiography, Abdominal/mt [Methods]
KW  - *Tomography, X-Ray Computed
KW  - Aged
KW  - Aged, 80 and over
KW  - Angioplasty, Balloon, Coronary/mo [Mortality]
KW  - Chi-Square Distribution
KW  - District of Columbia
KW  - Erythrocyte Transfusion
KW  - Female
KW  - Hemodynamics
KW  - Hemorrhage/et [Etiology]
KW  - Hemorrhage/mo [Mortality]
KW  - Hemorrhage/pp [Physiopathology]
KW  - Hospital Mortality
KW  - Humans
KW  - Hypotension/et [Etiology]
KW  - Hypotension/ra [Radiography]
KW  - Hypotension/th [Therapy]
KW  - Logistic Models
KW  - Male
KW  - Middle Aged
KW  - Myocardial Infarction/et [Etiology]
KW  - Myocardial Infarction/ra [Radiography]
KW  - Myocardial Infarction/th [Therapy]
KW  - Platelet Aggregation Inhibitors/ae [Adverse Effects]
KW  - Predictive Value of Tests
KW  - Prognosis
KW  - Retroperitoneal Space/ra [Radiography]
KW  - Retrospective Studies
KW  - Risk Assessment
KW  - Risk Factors
KW  - Shock, Hemorrhagic/et [Etiology]
KW  - Shock, Hemorrhagic/ra [Radiography]
KW  - Shock, Hemorrhagic/th [Therapy]
KW  - Stroke/et [Etiology]
KW  - Stroke/ra [Radiography]
KW  - Stroke/th [Therapy]
KW  - Time Factors
KW  - MedStar Heart & Vascular Institute
KW  - Comparative Study
KW  - Journal Article
N1  - Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006
N2  - BACKGROUND: Retroperitoneal hemorrhage (RPH) is a serious but infrequent complication of percutaneous coronary intervention (PCI). This study aimed to describe the clinical outcomes of patients who developed RPH following PCI in the current practice era, with particular focus on treatment strategies and the related prognostic value of abdominal/pelvic computed tomography (CT); CONCLUSIONS: RPH remains as a serious complication of PCI and is associated with high rates of mortality and morbidity independently of the therapeutic strategy. In patients who were hemodynamically stable, RPH volume as quantified by non-contrast abdominal/pelvic CT did not contribute to prognosis. Copyright  2011 Wiley Periodicals, Inc; METHODS: Among 20,904 patients undergoing PCI, we identified 93 RPH (0.45%) confirmed by CT or by unequivocal surgical findings. We identified three groups with RPH for comparison: patients who developed refractory shock (systolic blood pressure <80 mm Hg for >=30 min despite fluids and vasopressors, n = 16 [17.2%]); patients with transient hypotension (<30 min, n = 34 [36.6%]); and patients without hypotension (n = 43 [46.2%]). The primary endpoint was a composite of in-hospital mortality, myocardial infarction, and cerebral vascular accident (CVA); RESULTS: Baseline clinical, angiographic, and procedural characteristics were similar among the three groups. Patients who developed refractory shock had significantly more bleeding quantified by abdominal/pelvic CT (P < 0.001), had a higher rate and amount of red blood cell transfusion (P < 0.001), and were managed invasively more frequently (68.7%) than the rest of the population. The primary endpoint trended higher in patients presenting with refractory shock; however, this difference was not statistically significant. The volume of bleeding quantified by CT and the timing of imaging diagnosis did not correlate with the primary endpoint. Red blood cell transfusion, but not clopidogrel discontinuation, was associated with the primary endpoint
UR  - http://dx.doi.org/10.1002/ccd.23200
ER  -