Ralph Kickuth1,2, Hanno Hoppe1,3, Bettina Saar1,4, Daniel Inderbitzin5,6, Jürgen Triller1,7, Susanne Raessler8, Jürgen Gschossmann9,10. 1. Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, University of Bern, Bern, Switzerland. 2. Department of Radiology, University of Wuerzburg, Würzburg, Germany. 3. Department of Radiology, Lindenhofspital, Bern, Switzerland. 4. Department of Radiology, Hirslanden Klinik, Aarau, Switzerland. 5. Department of Visceral Surgery and Medicine, Inselspital, University of Bern, Bern, Switzerland. 6. Department of Surgery, soH Solothurner Spitäler, Solothurn, Switzerland. 7. Department of Radiology, Spital Emmental, Burgdorf/Langnau, Switzerland. 8. Department of Statistics, University of Bamberg, Bamberg, Germany. 9. Department of Visceral Surgery and Medicine, Inselspital, University of Bern, Bern, Switzerland. irene.gschossmann@t-online.de. 10. Department of Internal Medicine, Klinikum Forchheim, Forchheim, Germany. irene.gschossmann@t-online.de.
Abstract
PURPOSE: To evaluate the efficacy of superselective transcatheter arterial embolization (TAE) in the treatment of acute peripancreatic bleeding complications. METHODS: During a 9-year period, 44 patients with acute bleeding of the peripancreatic arteries underwent TAE in our institution. Thirty-eight patients were treated using microcatheters and 6 patients with a diagnostic catheter. Embolic agents included coils (n = 38), polyvinyl alcohol (PVA) particles (n = 2), isobutyl cyanoacrylate (n = 2), coils plus PVA particles (n = 1), and coils plus isobutyl cyanoacrylate (n = 1). Outcome measures included technical success, clinical success, and the rate of complications. RESULTS: Identified bleeding sources included gastroduodenal artery (n = 14), splenic artery (n = 9), pancreaticoduodenal artery (n = 6), common hepatic artery (n = 5), superior mesenteric artery branches (n = 4), proper hepatic artery (n = 3), and dorsal/transverse pancreatic artery (n = 3). Technical success with effective control of active bleeding was achieved in 41/44 patients (93 %). Clinical success attributed to TAE alone was documented in 40/44 patients (91 %). The rate of major complications was 2 % including death in one patient. CONCLUSIONS: Superselective TAE allows effective, minimally invasive control of acute peripancreatic bleeding complications with a low rate of therapeutically relevant complications.
PURPOSE: To evaluate the efficacy of superselective transcatheter arterial embolization (TAE) in the treatment of acute peripancreatic bleeding complications. METHODS: During a 9-year period, 44 patients with acute bleeding of the peripancreatic arteries underwent TAE in our institution. Thirty-eight patients were treated using microcatheters and 6 patients with a diagnostic catheter. Embolic agents included coils (n = 38), polyvinyl alcohol (PVA) particles (n = 2), isobutyl cyanoacrylate (n = 2), coils plus PVA particles (n = 1), and coils plus isobutyl cyanoacrylate (n = 1). Outcome measures included technical success, clinical success, and the rate of complications. RESULTS: Identified bleeding sources included gastroduodenal artery (n = 14), splenic artery (n = 9), pancreaticoduodenal artery (n = 6), common hepatic artery (n = 5), superior mesenteric artery branches (n = 4), proper hepatic artery (n = 3), and dorsal/transverse pancreatic artery (n = 3). Technical success with effective control of active bleeding was achieved in 41/44 patients (93 %). Clinical success attributed to TAE alone was documented in 40/44 patients (91 %). The rate of major complications was 2 % including death in one patient. CONCLUSIONS: Superselective TAE allows effective, minimally invasive control of acute peripancreatic bleeding complications with a low rate of therapeutically relevant complications.
Authors: Mehmet Murat Bala; Abdullah Alper Şahin; Mehmet Boz; Yasin Durukan; Tülin Fırat; Murat Pakdil; Kutay Engin Özturan Journal: Med Sci Monit Date: 2021-09-06