Massive Hemorrhage from Arterial Access during Intracranial Aneurysm Stent-Assisted Embolization: Endovascular Diagnosis and Therapy

Abstract

Massive hemorrhage from arterial access in patients receiving anticoagulation and antiplatelet therapy is a rare but potentially devastating complication. The authors present a patient who developed a large retroperitoneal and anterior abdominal wall hemorrhage following an unintentional and unrecognized arterial injury during an endovascular procedure. Reversal of anticoagulation in patients who have undergone stent-assisted coil embolization of intracranial aneurysms is an undesirable approach due to the risk of thromboembolism; rather, transcatheter embolization of the bleeding source should be considered.

Keywords

inferior epigastric - embolization - hemorrhage - anticoagulation - interventional radiology

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