The use of cyanoacrylate in the treatment of angiodysplasias: A safe and cheap alternative to coils

Abstract

Gastrointestinal angiodysplasia (GIAD) represents one of the most frequent causes of recurrent lower gastrointestinal bleeding in the elder population. Clinical manifestations are highly variable, diagnosis is done with colonoscopy or CT and management consists of either endoscopic or, more conservatively, endovascular approach. Trans-arterial embolization (TAE) reduces blood flow into the lesion and may complicate with perforation, dissection, vasospasm and bowel ischaemia. To date, coils and Gelfoam represent the most employed embolizing agents, followed by PVA and onyx. We report the successful embolization of GIADs in four patients with n-butyl 2-cyanoacrylate (NBCA) and Lipiodol Ultra-Fluid (LUF): despite the reported higher risk of bowel infarction when compared with the other agents, no major complication or short-term recurrence occurred in Our series.

Endovascular management of severe lower gastrointestinal bleeding from angiodysplasia in the cecum: A case report

“…To date, success rates have reached 80%-100%; failure (20%) can be encountered by following problems such as vessel perforation, dissection, spasm, bleeding cessation, or vessel tortuosity. Early rebleeding (<30 days) occurs in 10%-30% of cases as the result of the recanalization of previously embolized vessels or new sources of bleeding [10] .…”

“…Pitrone et al. reported successfully treating GIAD with NBCA in 4 patients with no sign of bowel infarction or clinical recurrence within the first 2 years postoperatively [10] . In our case, we performed abdominal MSCT 3 days after the procedure and did not detect any sign of bowel infarction.…”