Transcatheter arterial embolization with N-butyl cyanoacrylate for arterial esophageal bleeding in esophageal cancer patients

Aoki, Makoto; Tokue, Hiroyuki; Koyama, Yoshinori; Tsushima, Yoshito; Oshima, Kiyohiro

doi:10.1186/s12957-016-0803-y

Cited by 14 publications

(12 citation statements)

References 24 publications

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“…The left gastric artery was the main tumor-feeding arteries for cancer in esophageal cardia junction [2], and the bronchial artery may responsible for the blood supply for upper and middle esophageal carcinoma. Transarterial embolization can be used for in esophageal cancer patients with esophageal bleeding [13,14]. Transarterial infusion chemotherapy has been used in patients with T3 esophageal squamous carcinoma after radical surgery [10].…”

Section: Discussionmentioning

confidence: 99%

“…Temporary embolic material, absorbable gelatin sponge, was the most commonly used in order to avoid visceral perforation. However, permanent embolic material including PVA and N-butyl cyanoacrylate can be used for esophageal bleeding in esophageal cancer patients to avoid artery recanalization [13,14]. As a novel drug delivery system, DEB-TACE has been widely used for the treatment of unresectable hepatocellular carcinoma [8,9], refractory lung cancer and so on [15][16][17][18][19].…”

Section: Discussionmentioning

confidence: 99%

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Clinical outcomes of doxorubicin-eluting CalliSpheres® beads-transarterial chemoembolization for unresectable or recurrent esophageal carcinoma

Shi

Ren

et al. 2021

BMC Gastroenterol

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Background The clinical outcomes of drug-eluting beads transarterial chemoembolization (DEB-TACE) with doxorubicin-loaded CalliSpheres® beads for patients with unresectable or recurrent esophageal carcinoma have not been reported. The aim of this study is to study the clinical outcomes of DEB-TACE for patients with unresectable or recurrent esophageal carcinoma. Methods This retrospective study enrolled 21 patients (15 men; mean age 68.7 ± 9.7; range 46–86 years) with unresectable or recurrent esophageal carcinoma received DEB-TACE between July 2017 and September 2020. Patient characteristic data, imaging findings, complications and DEB-TACE procedure were reviewed. The primary endpoints, disease control rate (DCR) and objective response rate (ORR), were calculated. The secondary endpoints were overall survival rate and progression-free survival (PFS). Results Twenty-two sessions of DEB-TACE were performed in 21 patients. The technical success rate was 100%; without sever adverse events or procedure-related deaths. All patients received transarterial chemotherapy infusion with raltitrexed or oxaliplatin. The median follow-up period was 3.6 months (interquartile range, IQR 1.5–9.4 months). ORR and DCR were 42.9 and 85.7%, 28.6 and 71.4%, 20.0 and 40.0% respectively at 1-, 3-, and 6-months after DEB-TACE. The median PFS was 6.0 months, and the 3-, 6- and 12-month PFS rates were 68.2%, 45.5 and 0.0%, respectively. The median overall survival was 9.4 months, and the 3-, 6- and 12-month overall survival rates were 75.5%, 55.0 and 13.8%, respectively. Conclusions To our knowledge, this is the first study reports outcomes of DEB-TACE with doxorubicin-loaded CallSpheres bead treatment in the management of patients with unresectable or recurrent esophageal carcinoma. According to our results, this is a safe and feasible treatment modality that may be considered among the options for the treatment of these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of doxorubicin-eluting CalliSpheres® beads-transarterial chemoembolization for unresectable or recurrent esophageal carcinoma

Shi

Ren

et al. 2021

BMC Gastroenterol

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“…Considering the incidence rate of 5.6% and no other risk factors, TAE is the most possible culprit in inducing EP in this patient. In fact, TAE with NBCA has been used for esophageal bleeding for many years (18,19). The use of NBCA is advantageous for patients with coagulopathy and it has high success rate of occlusion.…”

Section: Discussionmentioning

confidence: 99%

Esophageal perforation during neoadjuvant chemoradiotherapy for esophageal cancer following transcatheter arterial embolization: a case report

Lu¹,

Wang²,

Chen³

et al. 2021

Ther Radiol Oncol

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Esophageal perforation (EP) is a rare disease mostly caused by iatrogenic endoscopic procedures.Esophageal cancer accounts for ten percent of them, and EP under such circumstance could be more complicated and often leads to poor outcome. Therefore, early recognition is of vital importance to prolong survival. To our knowledge, this is the first case report to propose the possible role of transcatheter arterial embolization (TAE) in EP. A 58-year-old female with stage III esophageal cancer (cT3N1M0) was presented to our emergency room. Four months before, she had received TAE because of tumor bleeding and then underwent neoadjuvant concurrent chemoradiotherapy (CRT) after recovery. Prior completion of CRT, dizziness, vomiting, chest tightness and chest pain developed. On examination, fever up to 38.8 degrees was found, accompanied with increased infiltration over the bilateral lungs on the chest radiograph. Under the initial impression of pneumonia, she was first managed with antibiotics and fluid hydration. However, drop of blood pressure occurred six hours later and emergent computed tomography of chest revealed pneumomediastinum and pericardial effusion. Upper gastrointestinal endoscopy showed severe mucosal breakage and EP was confirmed. Broad-spectrum antibiotics and fluid resuscitation were subsequently initiated. Pericardial window was also performed due to cardiac tamponade and the bacterial culture from the mediastinal fluid yielded Pseudomonas aeruginosa. Placement of metal stent was advised but refused by her family. With supportive care only, the patient died one month later due to progressive sepsis and multiorgan failure. EP may occur during CRT if there are risk factors such as T4 primary tumor, age more than 60 or extracapsular lymph node that involves the esophagus. In our case, we thought previous TAE is another factor that possibly contribute to the EP via generation of ischemia and alteration of healing microenvironment. In this setting, risk of EP should be carefully evaluated when subsequent CRT is attempted.

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“…and Tajima et al. also reported cases with chemoradiotherapy related AEF [ 10 , 11 ]. Our case had history of previous vascular surgery.…”

Section: Discussionmentioning

confidence: 99%

Massive upper gastrointestinal bleeding caused by an intercostal arterio-esophageal fistula: A rare case report

Yang

Lin

Huang

et al. 2020

Radiology Case Reports

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Arterio-esophageal fistula (AEF) is a rare life-threatening cause of upper gastrointestinal bleeding. Realizing the risk factors and clinical presentations of AEF will enable us to provide timely diagnosis, efficient treatment, and better outcome. We present a 43-year-old Taiwanese man who had histories of destructive lung, innominate artery-trachea fistula, and received bilobectomy. He was admitted to our hospital with fresh blood drainage from nasogastric tube. He was diagnosed as right fifth intercostal artery esophageal fistula by computed tomography angiography and transcatheter arterial embolization was performed. The bleeding stopped and the patient was discharged uneventfully. The risk factors of AEF include esophageal foreign body, vascular surgery, thoracic arterial malformations, and concurrent chemoradiotherapy in T4-esophageal cancer. Computed tomography angiography may be the most sensitive diagnostic test. Transcatheter arterial embolization or endovascular stent grafting may be considered as the first-line treatment of AEF in the future.

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Transcatheter arterial embolization with N-butyl cyanoacrylate for arterial esophageal bleeding in esophageal cancer patients

Cited by 14 publications

References 24 publications

Clinical outcomes of doxorubicin-eluting CalliSpheres® beads-transarterial chemoembolization for unresectable or recurrent esophageal carcinoma

Clinical outcomes of doxorubicin-eluting CalliSpheres® beads-transarterial chemoembolization for unresectable or recurrent esophageal carcinoma

Esophageal perforation during neoadjuvant chemoradiotherapy for esophageal cancer following transcatheter arterial embolization: a case report

Massive upper gastrointestinal bleeding caused by an intercostal arterio-esophageal fistula: A rare case report

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