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Efficacy and safety of superselective trans-catheter arterial embolization of upper and lower gastrointestinal bleeding using N-butyl-2-cyanoacrylate

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Abstract

Purpose

To evaluate the efficacy and safety of superselective trans-catheter arterial embolization (TAE) with N-butyl-2-cyanoacrylate (NBCA) for patients with acute non-variceal upper and lower gastrointestinal (GI) bleeding.

Methods

TAE using NBCA was performed in 21 patients (13 males, 8 females, mean age 60.9 years) with acute non-variceal upper (n = 15) and lower (n = 6) GI bleeding. TAE using other embolic agents was performed in 25 patients (13 males, 12 females, mean age 69.1 years) with acute non-variceal upper (n = 16) and lower (n = 9) GI bleeding. Technical success, clinical success, clinical failure, major and minor complications, bleeding-related 30-day mortality, and overall in-hospital mortality were analyzed.

Results

In 21 patients who underwent TAE with NBCA, the overall technical success was 100% (21/21) and overall clinical success was 72.2% (13/18). Uncontrolled bleeding, recurrent bleeding, and clinical failure were seen in 11.1% (2/18), 16.7% (3/18), and 27.8% (5/18) of cases, respectively. The minor complication rate was 16.7% (4/21) and no major complications occurred. Three patients showed ischemic damage in the treated lesion and one patient showed epigastric pain. The bleeding-related 30-day mortality and overall in-hospital mortality rates were 16.7% (3/18) and 28.6% (6/21), respectively. Two patients died of septic shock and one died of myocardial infarction within 30 days after TAE. In 25 patients who underwent TAE with other agents, the overall technical success was 100% (25/25), and the overall clinical success was 68.2% (15/22). The rates of uncontrolled bleeding, recurrent bleeding, clinical failure, bleeding-related 30-day mortality, and overall in-hospital mortality were 0.5% (1/22), 22.7% (5/22), 31.8% (7/22), 22.7% (5/22), and 32.0% (8/25), respectively.

Conclusions

TAE with NBCA for acute non-variceal upper and lower GI bleeding proved to be a technically feasible, safe, and effective treatment modality. Thus, NBCA could be used as a primary embolic agent for controlling GI bleeding.

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Authors and Affiliations

  1. Department of Radiology, Dongguk University Ilsan Hospital, Dongguk University Graduate School of Medicine, 27 Dongguk-ro, Siksa-dong, Ilsandong-gu, Gyeonggi-do, Goyang, 10326, South Korea

    Jae Hyun Kwon & Yoon Hee Han

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  1. Jae Hyun Kwon
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Correspondence to Jae Hyun Kwon.

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This study was approved by our hospital’s institutional review board. The requirement for informed consent was waived.

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The authors declare that they have no conflicts of interest.

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Kwon, J.H., Han, Y.H. Efficacy and safety of superselective trans-catheter arterial embolization of upper and lower gastrointestinal bleeding using N-butyl-2-cyanoacrylate. Emerg Radiol 25, 111–120 (2018). https://doi.org/10.1007/s10140-017-1552-0

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  • DOI: https://doi.org/10.1007/s10140-017-1552-0

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