Emergency percutaneous transcatheter embolisation of acute arterial haemorrhage

Keeling, Aoife N.; McGrath, F.; Thornton, John; Brennan, Paul; Lee, M. J.

doi:10.1007/s11845-009-0400-y

Cited by 12 publications

(15 citation statements)

References 14 publications

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“…Transarterial embolization is a less invasive and useful treatment for arterial bleeding . However, identification of extravasation by DSA alone is frequently difficult, especially in cases with relatively low‐level arterial bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…Transarterial embolization is a less invasive and useful treatment for arterial bleeding. 1,2,8,9 However, identification of extravasation by DSA alone is frequently difficult, especially in cases with relatively low-level arterial bleeding. Selective catheterization in the branches suspected of being responsible for bleeding may result in repeated DSA runs, the use of a large volume of contrast material, and an extended procedural time.…”

Section: Discussionmentioning

confidence: 99%

“…Transarterial embolization (TAE) plays an important role in the management of acute arterial bleeding, and it has now been established as a standard first-line treatment option. 1,2 The advancement of microcatheter-guidewire technologies has enabled catheterization into small branches, improvement of the technical success of TAE, and reduction of ischaemic tissue damage in the embolized vascular territory. In TAE for acute arterial bleeding, an accurate and prompt identification of the injured vessel is essential; however, this is sometimes difficult, and repeated selective angiography is required.…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of dual‐phase cone‐beam computed tomography during arteriography and automated tumour‐feeder detection software in transarterial embolization for obscure arterial bleeding in the abdomen

et al. 2018

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We report the usefulness of dual-phase cone-beam computed tomography during angiography (CBCTA) and automated tumour-feeder detection software (AFD) in transarterial embolization (TAE) for three consecutive cases of obscure arterial bleeding in the abdomen. Two patients presented with lower gastrointestinal bleeding and one showed bleeding into the pancreatic pseudocyst. Superior mesenteric or common hepatic angiography did not demonstrate extravasation, but dual-phase CBCTA and AFD could identify extravasation and an access route to the bleeding point. TAE with gelatin sponge particles and a microcoil was successfully performed under AFD guidance in all patients without any complication, and haemostasis could be achieved.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Usefulness of dual‐phase cone‐beam computed tomography during arteriography and automated tumour‐feeder detection software in transarterial embolization for obscure arterial bleeding in the abdomen

et al. 2018

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“…Digital subtraction angiography‐guided interventional embolisation appears to be most useful in patients who do not respond to conservative treatment, those with high surgical risks or patients unlikely to tolerate bowel preparation and urgent colonoscopy . Treatment decisions for patients with LGIB are widely varied in the literature and are often based on local expertise and preference .…”

Section: Introductionmentioning

confidence: 99%

Analysis of time delay between computed tomography and digital subtraction angiography on the technical success of interventional embolisation for treatment of lower gastrointestinal bleeding

Bruce

Erskine

2019

J of Medical Radiation Sci

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Introduction A retrospective study was undertaken to determine a potential relationship, based on the time delay, between a positive lower gastrointestinal bleed demonstrated on computed tomography (CT) and a positive digital subtraction angiographic (DSA) study and the impact on technical success. Methods This study investigated the correlation of time delays between imaging modalities and technical success with endovascular embolisation procedures over a 10‐year period. Results A total of 110 patient events were analysed, and it was observed that the greater the time delay between modalities (up to 7 h), the weaker the correlation between a bleed observed on CT and DSA. This was also reflected by the technical success of the embolisation treatment. Patients experienced shorter delays when the event occurred out of normal business hours, however with decreased rates of technical success. Conclusions There is a suggestion patients should be escalated to the angiography suite for DSA imaging as soon as possible to maximise the ability to angiographically observe acute bleeding and treat appropriately with interventional embolisation. More research in this area is required to statistically confirm this.

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“…However, when DSA does not clearly display extravasation or pseudoaneurysm, particularly when only tumor staining is observed, there is no established consensus regarding the type of embolic material that should be utilized. In a recent study, it was reported that TAE with EmboSpheres for life-threatening hemorrhages in patients with gastric cancer [10,11], breast cancer [12] and neurofibroma [13] was safe and effective. Calibrated microspheres are able to access distal regions of the target arteries resulting in disappearance of tumor staining.…”

Section: Introductionmentioning

confidence: 99%

Salvage Embolization and Histologic Analysis of Gastric Cancer with Hemorrhagic Shock Using Spherical Embolic Material

et al. 2018

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SummaryBackgroundIn a recent study, it was reported that transcatheter arterial embolization with spherical embolic material for life-threatening hemorrhages in various cancer patients was safe and effective. Calibrated microspheres are able to access distal regions of the target arteries, which results in the disappearance of tumor staining. However, there are few reports on the pathological behavior of EmboSpheres in gastric cancer specimens. In this case, we succeeded in salvage embolization for advanced gastric cancer with hemorrhagic shock using spherical embolic material. To our knowledge, this is the first report of a pathological evaluation of spherical embolic microspheres in a gastric cancer specimen.Case ReportA 70-year-old man with scirrhous gastric cancer was admitted to our hospital for staging laparoscopy. Unfortunately, he had a sudden onset of hematemesis and melena leading to hemorrhagic shock due to bleeding from the gastric cancer. While undergoing a rapid blood transfusion, he underwent emergent embolization to achieve hemostasis. The left gastric and right gastroepiploic arteries were embolized with spherical embolic material, and the patient survived. Two days later, the patient was able to undergo gastrectomy. A large number of microspheres were observed in areas of hemorrhage. The range and median diameter of the minor axis were 177–1048 μm and 281 μm, respectively.ConclusionsTranscatheter arterial embolization using spherical embolic material could become one of safe and effective options, especially when there is no extravasation or pseudoaneurysm but only tumor staining from the clinical and pathological point of view.

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Emergency percutaneous transcatheter embolisation of acute arterial haemorrhage

Abstract: Emergency arterial embolisation is a potentially life-saving treatment. Although it is technically challenging, indications are becoming increasingly varied and outcomes are more successful because of the availability of microcatheters and effective embolisation materials.

Cited by 12 publications

References 14 publications

Usefulness of dual‐phase cone‐beam computed tomography during arteriography and automated tumour‐feeder detection software in transarterial embolization for obscure arterial bleeding in the abdomen

Usefulness of dual‐phase cone‐beam computed tomography during arteriography and automated tumour‐feeder detection software in transarterial embolization for obscure arterial bleeding in the abdomen

Analysis of time delay between computed tomography and digital subtraction angiography on the technical success of interventional embolisation for treatment of lower gastrointestinal bleeding

Salvage Embolization and Histologic Analysis of Gastric Cancer with Hemorrhagic Shock Using Spherical Embolic Material

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