Transhepatic embolization in patients with acute variceal hemorrhage

Turner, William W.; Ellman, Brian A.

doi:10.1016/0002-9610(81)90322-6

Cited by 8 publications

(4 citation statements)

References 9 publications

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“…In Japan, it has been used during hysterosalpingography and lymphangiography. When NBCA is mixed with Lipiodol, the NBCA becomes radiopaque, and its polymerization time is increased [119,131,168,182]. The intravascular administration of Lipiodol is not approved for use by the Japanese pharmaceutical law or in any other country except France.…”

Section: International Situationmentioning

confidence: 99%

Guidelines for the use of NBCA in vascular embolization devised by the Committee of Practice Guidelines of the Japanese Society of Interventional Radiology (CGJSIR), 2012 edition

et al. 2014

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Section: International Situationmentioning

confidence: 99%

Guidelines for the use of NBCA in vascular embolization devised by the Committee of Practice Guidelines of the Japanese Society of Interventional Radiology (CGJSIR), 2012 edition

et al. 2014

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“…When NBCA is mixed with Lipiodol, NBCA becomes radiopaque and its polymerization time is increased. [ 2 3 4 ] It is necessary to change the NBCA-Lipiodol mixing ratio depending on the situation. The amount of Lipiodol should be decreased when attempting to embolize short segments, and it should be increased when attempting to embolize long segments.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the time course of changes in imaging findings of small arteries embolized with the N-Butyl cyanoacrylate-lipiodol mixture

Tokue

Tsushima

2018

Indian Journal of Radiology and Imaging

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Background:There are no reports analyzing imaging findings of arteries embolized with N-butyl cyanoacrylate (NBCA)-Lipiodol. To evaluate the time course of changes in the imaging findings of small arteries embolized with NBCA-Lipiodol.Materials and Methods:Selective transcatheter arterial embolization procedures via the inferior phrenic artery (right IPA, n = 25; left IPA, n = 5) were performed in 30 patients (25 males, 5 females; mean age 63 years, range: 45–78) at our institution. The NBCA-Lipiodol mixture was used as an embolic agent. The ratio of NBCA to Lipiodol was 1:4 (Group-A, n = 16) or 1:8 (Group-B, n = 14).We retrospectively reviewed the computed tomography (CT) findings and outcomes of small arteries embolized with the NBCA-Lipiodol mixture. The residual lipiodol was compared between Group-A and Group-B. The Student's t-test and Chi-square test were used for statistical analyses. In addition, the residual lipiodol rate was calculated using the Kaplan–Meier method and compared using the log-rank test.Results:The mean observation period was 264 ± 84 days (range: 104–425). Lipiodol completely disappeared in 20 arteries (66%) during follow-up. Recanalization of arterial flow was not seen in CT images, even when Lipiodol disappeared. Group-B showed a shorter period of progression to disappearance of Lipiodol than Group-A (P < 0.05). On follow up, the rate of residual Lipiodol in Group-A was higher than that in Group-B (P < 0.05).Conclusion:Residual Lipiodol was expected to gradually disappear. Lipiodol disappeared early when the density of NBCA was low in the NBCA-Lipiodol mixture. Further evaluations of various arteries and ratios of NBCA to Lipiodol are needed.

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“…Turcotte's group [24] found a 35% operative mortality rate and 17% 5year survival rate for their cirrhotic patients who required urgent portal systemic shunts. The risks of percutaneous transhepatic coronary vein embolization [25] are largely eliminated by the minilaparotomy option in patients with shrunken livers, ascites, and coagulopathy [15,16]. In addition, the methodology for the intravascular obliteration of variceal collaterals is steadily improving and the use of absolute ethanol through a coaxial catheter beyond the main coronary vein produces internal Meon Percentoge Decreose = 18.64% Fig.…”

Section: Discussionmentioning

confidence: 99%

Splenic artery and coronary vein occlusion for bleeding esophageal varices

et al. 1984

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Fifty consecutive, unselected, endoscopicaily confirmed patients with bleeding esophageal varices received splenic artery and coronary vein occlusion as their primary treatment. This was accomplished surgically in the first 30 patients and by interventional angiography in the last 20. The in-hospital mortality rate was 22% and the actuarial 5year survival rate was 52%. The incidence of recurrent gastrointestinal bleeding from all causes was 43.6% with a mortality rate of 13%.The mean decrease in portal pressure was 8.5 cm H20, and subsequent angiograms in 14 survivors revealed significant increases in the diameter of the proper hepatic artery, and decreases in the diameter of the portal vein. Hepatic function improved in 10 of the 32 Child's class B cirrhotics. The increase in the blood platelets of the survivors was statistically significant when compared with the decline in those who died.The long-term results of splenic artery and coronary vein occlusion, performed surgically or angiographically, compare favorably with other methods used to control bleeding esophageal varices.

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Transhepatic embolization in patients with acute variceal hemorrhage

Cited by 8 publications

References 9 publications

Guidelines for the use of NBCA in vascular embolization devised by the Committee of Practice Guidelines of the Japanese Society of Interventional Radiology (CGJSIR), 2012 edition

Guidelines for the use of NBCA in vascular embolization devised by the Committee of Practice Guidelines of the Japanese Society of Interventional Radiology (CGJSIR), 2012 edition

Analysis of the time course of changes in imaging findings of small arteries embolized with the N-Butyl cyanoacrylate-lipiodol mixture

Splenic artery and coronary vein occlusion for bleeding esophageal varices

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