{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T05:39:04Z","timestamp":1792474744321,"version":"4.5.0"},"reference-count":20,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Ultrasound"],"abstract":"ABSTRACT<\/jats:title>\n \n Purpose<\/jats:title>\n \n Abdominal wall hematomas (\n AWHs<\/jats:styled-content>\n ) are relatively uncommon causes of acute abdominal pain but may represent potentially life\u2010threatening vascular emergencies, particularly in elderly patients receiving anticoagulant therapy or in the setting of significant hemorrhage. Transcatheter arterial embolization of the inferior epigastric artery is the recommended first\u2010line therapy. The contralateral femoral approach may be technically demanding in elderly patients with iliac tortuosity, calcifications, or diffuse atherosclerosis. This bicentric retrospective study compared ipsilateral versus contralateral femoral access for inferior epigastric artery embolization, evaluating procedural efficiency, radiation exposure, and clinical outcomes.\n <\/jats:p>\n <\/jats:sec>\n \n Material and Methods<\/jats:title>\n \n A bicentric retrospective study included 48 patients treated in emergency settings for epigastric artery bleeding between June 2022 and June 2025. Patients were divided into ipsilateral (\n n<\/jats:italic>\n \u2009=\u200923) or contralateral (\n n<\/jats:italic>\n \u2009=\u200925) femoral access groups, with further stratification by age (<\u200960 vs. \u2265\u200960\u2009years). Technical and clinical success, total angiographic procedure duration, fluoroscopic dose (Air Kerma,\n mGy<\/jats:styled-content>\n ), access\u2010site complications, transfusion requirements, rebleeding, and 30\u2010day\/3\u2010month survival were analyzed. A subgroup analysis in patients \u2265\u200960\u2009years (\n n<\/jats:italic>\n \u2009=\u200933) assessed the impact of vascular anatomy on procedural metrics.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Technical success was 100% in both groups, whereas clinical success was comparable between the contralateral and ipsilateral groups (96.00% vs. 95.65%, respectively). In patients \u2265\u200960\u2009years, ipsilateral access significantly reduced procedure time (27.90\u2009\u00b1\u20096.40 vs. 33.30\u2009\u00b1\u20098.30 min,\n p<\/jats:italic>\n \u2009=\u20090.046) and radiation dose (254.00 [\n IQR<\/jats:styled-content>\n 219.00\u2013272.00] vs. 283.50 [\n IQR<\/jats:styled-content>\n 248.80\u2013310.80]\n mGy<\/jats:styled-content>\n ,\n p<\/jats:italic>\n \u2009=\u20090.023). No major complications or significant between\u2010group differences in rebleeding or survival were observed. In exploratory multivariable analysis, ipsilateral access was associated with lower Air Kerma (\n \u03b2<\/jats:italic>\n \u2009=\u2009\u221256.43\n mGy<\/jats:styled-content>\n ; 95%\n CI<\/jats:styled-content>\n , \u221291.91 to \u221220.95;\n p<\/jats:italic>\n \u2009=\u20090.002), whereas the adjusted estimate for procedure duration was less precise and did not reach statistical significance.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Both femoral access routes are safe and effective. In patients aged \u2265\u200960\u2009years, ipsilateral access was associated with shorter procedure duration and lower radiation exposure in unadjusted analyses. Exploratory adjusted analyses suggested an association between ipsilateral access and lower radiation exposure, whereas the adjusted association with procedure duration was not statistically significant. These findings require confirmation in larger prospective cohorts.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jcu.70444","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T04:59:59Z","timestamp":1792472399000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ipsilateral Versus Contralateral Femoral Access for Inferior Epigastric Artery Embolization: Impact of Patient Age on Procedural Efficiency"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4226-4579","authenticated-orcid":false,"given":"Claudio","family":"Carrubba","sequence":"first","affiliation":[{"name":"Vascular and Interventional Radiology Department Cardarelli Hospital Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto","family":"Punzi","sequence":"additional","affiliation":[{"name":"Interventional Radiology Unit Hospital Avellino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9973-0593","authenticated-orcid":false,"given":"Felice","family":"D\u2032Antuono","sequence":"additional","affiliation":[{"name":"Vascular and Interventional Radiology Department Cardarelli Hospital Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Giurazza","sequence":"additional","affiliation":[{"name":"Vascular and Interventional Radiology Department Cardarelli Hospital Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Corvino","sequence":"additional","affiliation":[{"name":"Vascular and Interventional Radiology Department Cardarelli Hospital Naples Italy"},{"name":"Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND) University Hospital \u201cPaolo Giaccone\u201d Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0650-9292","authenticated-orcid":false,"given":"Francesco","family":"Pane","sequence":"additional","affiliation":[{"name":"Vascular and Interventional Radiology Department Cardarelli Hospital Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1563-6887","authenticated-orcid":false,"given":"Noemi","family":"Brignola","sequence":"additional","affiliation":[{"name":"Unit of Radiology and Diagnostic Imaging PO \u201cSanta Maria delle Grazie\u201d, ASL Napoli 2 Nord Pozzuoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Interventional Radiology Unit Hospital Avellino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaella","family":"Niola","sequence":"additional","affiliation":[{"name":"Vascular and Interventional Radiology Department Cardarelli Hospital Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,19]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvscit.2023.101232"},{"key":"e_1_2_12_3_1","first-page":"353","article-title":"Access, Hemostasis, and Closure Devices: Indications and Techniques in Interventional Radiology","volume":"31","author":"Barbetta I.","year":"2014","journal-title":"Seminars in Interventional Radiology"},{"key":"e_1_2_12_4_1","first-page":"163","article-title":"Spontaneous Retroperitoneal and Rectus\u2010Sheath Hematomas: Interventional Therapy and Outcomes","volume":"196","author":"Becker L. S.","year":"2023","journal-title":"RoFo: Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin"},{"key":"e_1_2_12_5_1","first-page":"1","article-title":"Computed Tomography Imaging in the Context of Transcatheter Aortic Valve Implantation (TAVI)\/Transcatheter Aortic Valve Replacement (TAVR): An Expert Consensus Document of the Society of Cardiovascular Computed Tomography","volume":"12","author":"Blanke P.","year":"2019","journal-title":"JACC: Cardiovascular Imaging"},{"key":"e_1_2_12_6_1","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1007\/s11547-023-01678-7","article-title":"The Prominent Role of Percutaneous Transarterial Embolization in the Treatment of Anterior Abdominal Wall Hematomas: Results From Three High\u2010Volume Tertiary Referral Centers","volume":"128","author":"Cacioppa L. M.","year":"2023","journal-title":"Radiologia Medica"},{"key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1007\/s00270-012-0339-7","article-title":"CIRSE Quality Improvement Guidelines for Endovascular Treatment of Traumatic Hemorrhage","volume":"35","author":"Chakraverty S.","year":"2012","journal-title":"Cardiovascular and Interventional Radiology"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11051270"},{"key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1177\/1538574420980576","article-title":"Transcatheter Embolization of the Inferior Epigastric Artery: Techniques and Clinical Outcomes","volume":"55","author":"Diamantopoulos A.","year":"2021","journal-title":"Vascular and Endovascular Surgery"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00270\u2010025\u201004200\u2010w"},{"key":"e_1_2_12_11_1","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.jvir.2017.08.006","article-title":"Modified N\u2010Butyl Cyanoacrylate Glue Embolization for Spontaneous Iliopsoas and Rectus\u2010Sheath Hematomas in Anticoagulated Patients","volume":"29","author":"Jawhari R.","year":"2018","journal-title":"Journal of Vascular and Interventional Radiology"},{"key":"e_1_2_12_12_1","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1016\/j.jvir.2012.06.006","article-title":"Antegrade Superficial Versus Common Femoral Artery Puncture for Infrainguinal Occlusive Disease","volume":"23","author":"Kweon M.","year":"2012","journal-title":"Journal of Vascular and Interventional Radiology"},{"key":"e_1_2_12_13_1","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1148\/rg.2017160098","article-title":"Don't Forget the Abdominal Wall: Imaging Spectrum of Abdominal Wall Injuries After Blunt Trauma","volume":"37","author":"Matalon S. A.","year":"2017","journal-title":"Radiographics"},{"key":"e_1_2_12_14_1","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1016\/j.jvs.2018.05.019","article-title":"Systematic Review of Vascular Closure Devices for Femoral Artery Puncture Sites","volume":"68","author":"Noori V. J.","year":"2018","journal-title":"Journal of Vascular Surgery"},{"key":"e_1_2_12_15_1","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1007\/s11547-015-0516-2","article-title":"Endovascular Embolization for Rectus\u2010Muscle Hematoma: Sustained Hemorrhage Control and Outcomes","volume":"120","author":"Pieri S.","year":"2015","journal-title":"Radiologia Medica"},{"key":"e_1_2_12_16_1","doi-asserted-by":"crossref","first-page":"297","DOI":"10.5152\/akd.2014.5311","article-title":"Predictors of Clinical Outcome in Transfemoral TAVI: Circumferential Iliofemoral Calcifications and Manufacturer\u2010Derived Recommendations","volume":"15","author":"Reinthaler M.","year":"2015","journal-title":"Anadolu Kardiyoloji Dergisi\/Anatolian Journal of Cardiology"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12144779"},{"key":"e_1_2_12_18_1","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.3390\/tomography8030101","article-title":"Spontaneous Retroperitoneal Hematoma Treated With Percutaneous Transarterial Embolization in the COVID\u201019 Era: CT Findings and Procedural Outcomes","volume":"8","author":"Tiralongo F.","year":"2022","journal-title":"Tomography"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD013637"},{"key":"e_1_2_12_20_1","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1007\/s00270-018-2086-x","article-title":"Transcatheter Arterial Embolization of Spontaneous Soft\u2010Tissue Hematomas: A Systematic Review","volume":"42","author":"Touma L.","year":"2019","journal-title":"Cardiovascular and Interventional Radiology"},{"key":"e_1_2_12_21_1","first-page":"49","article-title":"Spontaneous Abdominal Wall Hematoma Triggered by Violent Cough: Surgical Challenges and Outcomes From Three Cases and Literature Review","volume":"8","author":"Ungureanu C. O.","year":"2025","journal-title":"Report"}],"container-title":["Journal of Clinical Ultrasound"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcu.70444","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jcu.70444","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcu.70444","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T05:00:02Z","timestamp":1792472402000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcu.70444"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,19]]},"references-count":20,"alternative-id":["10.1002\/jcu.70444"],"URL":"https:\/\/doi.org\/10.1002\/jcu.70444","archive":["Portico"],"relation":{},"ISSN":["0091-2751","1097-0096"],"issn-type":[{"value":"0091-2751","type":"print"},{"value":"1097-0096","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,19]]},"assertion":[{"value":"2026-02-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jcu.70444"}}