Transarterial embolization with n-butyl cyanoacrylate for the treatment of abdominal wall hemorrhage

Autor: Valdair Francisco Muglia, Luis Henrique de Castro-Afonso, Jorge Elias-Junior, Tales Vieira Cavalcanti Albuquerque, Daniel Giansante Abud, Lucas Moretti Monsignore
Rok vydání: 2020
Předmět:
Male
medicine.medical_specialty
Superior epigastric artery
medicine.medical_treatment
Hemorrhage
Context (language use)
030218 nuclear medicine & medical imaging
Abdominal wall
03 medical and health sciences
0302 clinical medicine
Risk Factors
medicine.artery
Interventional Radiology
medicine
Humans
Radiology
Nuclear Medicine and imaging
Decompensation
Embolization
Inferior epigastric artery
Aged
Retrospective Studies
Aged
80 and over
medicine.diagnostic_test
business.industry
Liver Diseases
Abdominal Wall
Endovascular Procedures
Angiography
Digital Subtraction
Anticoagulants
Digital subtraction angiography
Enbucrilate
Middle Aged
Embolization
Therapeutic
Surgery
RESULTADO DE TRATAMENTO
Treatment Outcome
medicine.anatomical_structure
Chronic Disease
Angiography
Female
Cardiology and Cardiovascular Medicine
business
Zdroj: Diagn Interv Radiol
Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual)
Universidade de São Paulo (USP)
instacron:USP
ISSN: 1305-3612
Popis: Purpose We aimed to evaluate the effectiveness and safety of n-butyl cyanoacrylate (n-BCA) in the context of the transarterial embolization (TAE) of abdominal wall hemorrhage in an urgent scenario. Methods A retrospective study of cases admitted from January 2008 to December 2017 in the emergency unit of our institution revealed 11 patients with abdominal wall hemorrhage who underwent digital subtraction angiography and TAE with n-BCA. We analyzed the sex, age, hemorrhagic risk factors, etiology, embolized vessel, technical success (no rebleeding in the embolized area), clinical success (hemoglobin level control and hemodynamic stability after the procedure), complications inherent to the procedure, and clinical outcome (mortality in 30 days). Results The mean age was 63.4 years (52-83 years), with a predominance of the female sex (64%). The majority (91%) of patients presented hemorrhagic risk factors (chronic hepatopathy and anticoagulation drug usage). Spontaneous hemorrhage was present in 18% of patients, and the other 82% had an iatrogenic etiology. Technical success was achieved in 100% of the patients, which required the embolization of inferior epigastric artery in 10 patients (91%), circumflex iliac artery in 2 (18%), and superior epigastric artery in 1 (9%). Five patients were hemodynamically unstable, and despite achieving technical success, 4 (36%) died in less than 30 days due to decompensation of their clinical comorbidities caused by the acute phase. There were no complications inherent to the procedures. Conclusion The present study concludes that TAE with n-BCA is a safe and effective treatment for abdominal wall hemorrhage in an urgent scenario, with high rates of technical and clinical success.
Databáze: OpenAIRE
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