Statistics
- An estimated amount of 10% to 30% of patients who posses acute aortic syndrome encounter intramural hematoma (IMH) (1)
- The majority of patients who have IMH have Stanford type B (50%-85%)
- Type B – *Exclusive involvement of the descending aorta* (1)
- Some non-traumatic causes including conditions such as penetrating aortic ulcer (PAU) (1)
- The risk of developing such complications including pocket hematomas during and after CIED implantation increases to 14% including pre-existing thrombocytopenia and heparin bridging therapy and to 16.2% through dual antiplatelet therapy (DAP) (2)
- They are one of the most common complications of CIED implants.
- Pocket hematomas are associated with increased risk of mortality, longer stays in the hospital (3.6 days) and heightened medical costs (21%). (2)
- Pocket hematomas cause about 25% of early re-operations in patients with CIED implants (3).
Images:
Kutinsky, Ilana B., et al. “Risk of Hematoma Complications after Device Implant in the Clopidogrel Era.” Circulation: Arrhythmia and Electrophysiology, 17 June 2010, http://www.ahajournals.org/doi/10.1161/circep.109.917625.%5B/caption%5D
Citations:
- (1)Alomari, Ihab B., et al. “Aortic Intramural Hematoma and Its Complications.” Circulation, 11 Feb. 2014, http://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.113.001809.
- (2)Harsha Kanuri, Sri, et al. “Prevention and Treatment Strategies for Pocket Hematomas During CIED Implantation: Pocket Management Systems and Other Adjuvant Interventions.” Hmpgloballearningnetwork.com, EP Lab Digest , Dec. 2020, http://www.hmpgloballearningnetwork.com/site/eplab/prevention-and-treatment-strategies-pocket-hematomas-during-cied-implantation-pocket-management-systems-and-other-adjuvant-interventions
- (3)(Awada, H., Geller, J. C., Brunelli, M., & Ohlow, M. A, Journal of interventional cardiac electrophysiology)