Fatal pulmonary embolism of polyvinyl alcohol particles following therapeutic embolisation of a peripheral arteriovenous malformation

Wijeyaratne, Mandika; Ubayasiri, Ranjuka; Weerasinghe, Charitha

doi:10.1136/bcr.02.2009.1635

Cited by 7 publications

(3 citation statements)

References 18 publications

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“…Metallic coils, gelatin particles, microspheres, polyvinyl alcohol, N-butyl cyanoacrylate, and Onyx were used as embolic material. However, particulate embolic agents are not suitable for AVM management because those materials can pass through the AVM nidus and eventually lead to inadvertent venous embolism such as pulmonary infarction [ 8 ]. Meanwhile, coils and N-butyl cyanoacrylate can make proximal embolization, leaving the AVM nidus, which is considered a major recurrence factor after embolization.…”

Section: Discussionmentioning

confidence: 99%

Unusual Presentation of Anal Pain and Tenesmus from Rectal Arteriovenous Malformation Successfully Treated with Ethanol Sclerotherapy

Hong¹,

Lee²,

Guen³

et al. 2021

Case Rep Gastroenterol

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Gastrointestinal arteriovenous malformation (AVM) is reported as one of the possible causes of intestinal bleeding, and its occurrence in the rectum is rare. We report the case of a rectal AVM patient who experienced uncommon symptoms of anal pain and tenesmus and was treated successfully with percutaneous transarterial ethanol sclerotherapy. The patient underwent routine colonoscopy with biopsy at the time of visit; however, an accurate diagnosis was difficult. Subsequent contrast-enhanced computed tomography (CT) and angiography revealed a rectal AVM emerging from the distal inferior mesenteric artery with engorged superior rectal veins. The feeding artery was catheterized, and concurrent transarterial sclerotherapy with 80% ethanol was performed. There was no major complication related to the procedure. Disappearance of AVM nidus and improvement of associated venous congestion were shown by follow-up CT. There was no recurrence of symptoms after 10 months of clinical observation. Transarterial ethanol sclerotherapy is safe and effective in treating rectal AVM and can be considered as one of the nonsurgical treatment options.

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Section: Discussionmentioning

confidence: 99%

Unusual Presentation of Anal Pain and Tenesmus from Rectal Arteriovenous Malformation Successfully Treated with Ethanol Sclerotherapy

Hong¹,

Lee²,

Guen³

et al. 2021

Case Rep Gastroenterol

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“…In this case, we did not perform additional embolization in first session because adequate flow reduction was already obtained and if we performed further glue embolization via the right MMA under flow control of the right STA with PVA embolization, we were concerned about ischemic complications of the skin. Furthermore, in high-flow AVF, PVA can migrate to the venous side and cause pulmonary embolism 19 . Proximal compression and proximal balloon occlusion are very easy, but sometimes insufficient due to the plentiful collateral blood flow of the scalp.…”

Section: Discussionmentioning

confidence: 99%

The Usefulness of Subcutaneous Infiltration of Epinephrine-Containing Lidocaine for Curative Transarterial Embolization of Dural Arteriovenous Fistula

et al. 2014

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Recently, transarterial embolization (TAE) with liquid embolic materials has been recognized as one of the curative therapeutic options for non-sinus type dural arteriovenous fistula (d-AVF). To prevent glue fragmentation and incomplete obliteration, flow reduction of transosseous high-flow feeders is one of the key points of this therapy. However, flow reduction of transosseous feeders is sometimes difficult with previously reported techniques such as particle embolization, manual compression, or proximal balloon occlusion. This report introduces a new technique to reduce the flow of transosseous feeders using epinephrine-containing lidocaine, and describes a case of intracranial d-AVF successfully treated with this technique. The usefulness and efficacy of the technique are discussed.

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“…When dispersed in a physiological solution, PL easily forms aggregates, resulting in the formation of a turbid suspension, but not a solution. Intravenous administration of PL suspension to tumour-bearing animals or to cancer patients will inevitably result in embolism which may be fatal [10,11].…”

Section: Introductionmentioning

confidence: 99%

Liposomal Nanoformulation of Piperlongumine for Improved Aqueous Solubility and Enhanced Anti-tumour Activity In-vitro

Zhang¹

2018

Int J Pharm Pharmacol

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Piperlongumine (PL) is an alkaloid isolated from the Piper species, which can induce apoptosis in cancer cells but has little inhibitory effect on the growth of normal cells. However, its poor aqueous solubility has largely limited its therapeutic applications. To address this issue, we developed liposomal nanoformulations for PL (nanoPLs) in this study. The optimized nanoPLs exhibited a small average diameter in the range of 100-160 nm and narrow size distribution as well as high encapsulation efficiency. NanoPLs also demonstrated excellent storage stability at 4°C for 12 weeks. The apparent solubility of PL in NanoPLs was improved up to 312 folds than in PBS. NanoPLs also markedly increased the cytotoxicity of PL to human prostate cancer PC-3 cells when compared to free PL. NanoPLs represent promising and convenient injectable formulations of PL for further preclinical and clinical investigation.

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Fatal pulmonary embolism of polyvinyl alcohol particles following therapeutic embolisation of a peripheral arteriovenous malformation

Cited by 7 publications

References 18 publications

Unusual Presentation of Anal Pain and Tenesmus from Rectal Arteriovenous Malformation Successfully Treated with Ethanol Sclerotherapy

Unusual Presentation of Anal Pain and Tenesmus from Rectal Arteriovenous Malformation Successfully Treated with Ethanol Sclerotherapy

The Usefulness of Subcutaneous Infiltration of Epinephrine-Containing Lidocaine for Curative Transarterial Embolization of Dural Arteriovenous Fistula

Liposomal Nanoformulation of Piperlongumine for Improved Aqueous Solubility and Enhanced Anti-tumour Activity In-vitro

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