Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Efficacy of Transcatheter Arterial Embolization with N-Butyl Cyanoacrylate in Acute Bleeding Patient

급성 출혈 환자에서 N-Butyl Cyanoacrylate를 이용한 경도관 동맥색전술의 유용성

  • Jae, Hwan Jun (Department of Radiology, Seoul National University College of Medicine) ;
  • Kim, Sang Youn (Department of Radiology, Seoul National University College of Medicine) ;
  • Lee, Eui Jung (Department of Emergency Medicine, Seoul National University College of Medicine) ;
  • Lee, Whal (Department of Radiology, Seoul National University College of Medicine) ;
  • Suh, Gil Joon (Department of Emergency Medicine, Seoul National University College of Medicine)
  • 제환준 (서울대학교 의과대학 방사선과) ;
  • 김상윤 (서울대학교 의과대학 방사선과) ;
  • 이의중 (서울대학교 의과대학 응급의학과) ;
  • 이활 (서울대학교 의과대학 방사선과) ;
  • 서길준 (서울대학교 의과대학 응급의학과)
  • Received : 2005.10.27
  • Accepted : 2005.11.24
  • Published : 2005.12.30
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Abstract

Background: N-Butyl Cyanoacrylate (NBCA) is a liquid embolic material that can be useful for transcatheter arterial embolization (TAE) of acute bleeding especially in patients with coagulopathy, because it does not depend on coagulation for its therapeutic effect. The aims of this study were to evaluate the clinical efficacy and safety of TAE with NBCA in acute bleeding patients. Methods: Between August 2003 and September 2004, TAE using NBCA for acute bleeding was performed in 23 patients (16 men, 7 women; mean age, 56.5years). The causes of bleeding were gastric ulcer (n=5), postoperative bleeding (n=4), post-biopsy bleeding (n=3), postpartum bleeding (n=3), duodenal ulcer (n=2), angiodysplasia (n=2), gastric lymphoma (n=1), iatrogenic injury (n=1), CMV gastritis (n=1), stab injury of the liver (n=1). TAE was performed using 1:3 mixtures of NBCA and iodized oil. The angiographic and clinical success rate, recurrent bleeding rate, procedure-related complication and clinical outcomes were evaluated. Results: The angiographic and clinical success rate was 100% and 91.3% (21/23), respectively. There was no serious ischemic complication. Recurrent bleeding occurred in 2 patients (8.7%) and they were managed with successful second TAE (n=1) and endoscopic treatment (n=1). Nine patients (39.1%) had coagulopathy at the time of TAE and clinical success rate in this group of patients was 88.9% (8/9). Conclusions: TAE with NBCA is highly effective and safe treatment modality for acute bleeding patients, especially when the patient has a coagulopathy.

Keywords

References

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