1
|
Youm J, Choi MJ, Kim BM, Seo Y. Transcatheter embolization for hemorrhage from aberrant testicular artery after partial nephrectomy: A case report. World J Clin Cases 2023; 11:7852-7857. [DOI: 10.12998/wjcc.v11.i32.7852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 09/06/2023] [Accepted: 11/02/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Arterial bleeding typically involves the renal artery following partial nephrectomy; in this study, we present a case of bleeding originating from the testicular artery that has not been reported in previous studies.
CASE SUMMARY A 52-year-old man suffered hemorrhage from a perinephric branch of the aberrant left testicular artery after an open nephron-sparing surgery for renal cell carcinoma. Clinical signs of bleeding were manifested by the patient, such as fresh blood drainage from the catheter, decreased hemoglobin levels, and significant vital sign changes. Since computed tomography did not show evidence of active bleeding, transcatheter angiography was conducted to identify the bleeding site. Fluoroscopic spot images confirmed bleeding derived from a perinephric branch of the testicular artery originating from the segmental artery of the left renal artery. Using n-butyl-2-cyanoacrylate, successful transcatheter arterial embolization of the affected branch was performed. Immediately after the embolization procedure, the bleeding ceased, and the patient experienced complete recovery devoid of complications.
CONCLUSION In patients with postoperative arterial hemorrhage after partial nephrectomy, the testicular artery can be a rare but notable source of bleeding. Accurate bleeding site localization via angiographic evaluation, followed by transcatheter arterial embolization, can be instrumental for safe, prompt, and effective hemostasis.
Collapse
Affiliation(s)
- Juyoun Youm
- Department of Radiology, Dankook University Hospital, Cheonan 31116, South Korea
| | - Min-Jeong Choi
- Department of Radiology, Dankook University Hospital, Cheonan 31116, South Korea
| | - Bong Man Kim
- Department of Radiology, Dankook University Hospital, Cheonan 31116, South Korea
| | - Yumi Seo
- Department of Urology, Dankook University Hospital, Cheonan 31116, South Korea
| |
Collapse
|
2
|
Choi TW, Kwon Y, Kim J, Won JH. [Endovascular Treatment for Vascular Injuries of the Extremities]. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2023; 84:846-854. [PMID: 37559804 PMCID: PMC10407075 DOI: 10.3348/jksr.2023.0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/16/2023] [Accepted: 07/08/2023] [Indexed: 08/11/2023]
Abstract
Vascular injuries of the extremities are associated with a high mortality rate. Conventionally, open surgery is the treatment of choice for peripheral vascular injuries. However, rapid development of devices and techniques in recent years has significantly increased the utilization and clinical application of endovascular treatment. Endovascular options for peripheral vascular injuries include stent-graft placement and embolization. The surgical approach is difficult in cases of axillo-subclavian or iliac artery injuries, and stent-graft placement is a widely accepted alternative to open surgery. Embolization can be considered for arterial injuries associated with active bleeding, pseudoaneurysms, and arteriovenous fistula and in patients in whom embolization can be safely performed without a risk of ischemic complications in the extremities. Endovascular treatment is a minimally invasive procedure and is useful as a simultaneous diagnostic and therapeutic approach, which serve as advantages of this technique that is widely utilized for vascular injuries of the extremities.
Collapse
|
3
|
Kim HC, Jeong YS, Han K, Kim GM. Transcatheter arterial embolization of cystic artery bleeding. Front Surg 2023; 10:1160149. [PMID: 37114149 PMCID: PMC10126234 DOI: 10.3389/fsurg.2023.1160149] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/23/2023] [Indexed: 04/29/2023] Open
Abstract
Purpose The purpose of this study is to assess the safety and clinical outcomes of transcatheter arterial embolization (TAE) via the cystic artery for treating patients with bleeding from the cystic artery. Materials and Methods This retrospective study included 20 patients who underwent TAE via the cystic artery between January 2010 and May 2022. Radiological images and clinical data were reviewed to evaluate causes of bleeding, procedure-related complications, and clinical outcomes. Technical success was defined as the disappearance of contrast media extravasation or pseudoaneurysm, as demonstrated on completion angiography. Clinical success was defined as discharge from the hospital without any bleeding-related issues. Results Hemorrhagic cholecystitis (n = 10) was the most common cause of bleeding, followed by iatrogenic (n = 4), duodenal ulcer (n = 3), tumor (n = 2), and trauma (n = 1). Technical success was achieved in all cases, and clinical success was achieved in 70% (n = 14) of patients. Three patients developed ischemic cholecystitis as a complication. Six patients with clinical failure died within 45 days after embolization. Conclusion TAE through the cystic artery has a high technical success rate in treating cystic artery bleeding, but clinical failure remains a common occurrence due to concurrent medical conditions and the development of ischemic cholecystitis.
Collapse
Affiliation(s)
- Hyo-Cheol Kim
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yun Soo Jeong
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kichang Han
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Gyoung Min Kim
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Correspondence: Gyoung Min Kim
| |
Collapse
|
4
|
Transarterial Embolization for Spontaneous Soft-Tissue Hematomas: Predictive Factors for Early Death. J Pers Med 2022; 13:jpm13010015. [PMID: 36675676 PMCID: PMC9862993 DOI: 10.3390/jpm13010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/13/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION The aim of this retrospective monocentric study was to assess the safety and efficacy of spontaneous soft-tissue hematoma transarterial embolization (TAE) and to evaluate predictive factors for early mortality (≤30 days) after TAE for spontaneous soft-tissue hematoma (SSTH). MATERIALS AND METHODS Between January 2010 and March 2022, all patients referred to our hospital for spontaneous soft-tissue hematoma and treated by emergency TAE were reviewed. Inclusion criteria were patients: ≥18-year-old, with active bleeding shown on preoperative multidetector row computed tomography, with spontaneous soft-tissue hematoma, and treated by TAE. Exclusion criteria were patients with soft-tissue hematomas of traumatic, iatrogenic, or tumoral origin. Clinical, biological, and imaging records were reviewed. Imaging data included delimitation of hematoma volume and presence of fluid level. Univariate and multivariate analyses were performed to check for associations with early mortality. RESULTS Fifty-six patients were included. Median age was 75.5 [9-83] ([Q1-Q3] years and 23 (41.1%) were males. Fifty-one patients (91.1%) received antiplatelet agent and/or anticoagulant therapy. All 56 patients had active bleeding shown on a preoperative CT scan. Thirty-seven (66.0%) hematomas involved the retroperitoneum. Median hemoglobin level was 7.6 [4.4-8.2] g/dL. Gelatine sponge was used in 32/56 (57.1%) procedures. Clinical success was obtained in 48/56 (85.7%) patients and early mortality occurred in 15/56 (26.8%) patients. In univariate and multivariate analysis, retroperitoneal location and volume of hematoma were associated with early mortality. CONCLUSION Retroperitoneal location and volume of hematoma seem to be risk factors for early death in the context of TAE for spontaneous soft-tissue hematoma. Larger multicenter studies are necessary to identify others predictive factors for early mortality and to anticipate which patients may benefit from an interventional strategy with TAE.
Collapse
|
5
|
Transcatheter Arterial Embolization with N-butyl-2 Cyanoacrylate Glubran 2 for the Treatment of Acute Renal Hemorrhage Under Coagulopathic Conditions. Ann Vasc Surg 2022; 86:358-365. [DOI: 10.1016/j.avsg.2022.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 03/13/2022] [Accepted: 04/03/2022] [Indexed: 11/24/2022]
|
6
|
Patidar Y, Srinivasan SV, Singh J, Patel RK, Chandel K, Mukund A, Sharma MK, Sarin SK. Clinical Outcomes of Transcatheter Arterial Embolization Using N-butyl-2-cyanoacrylate (NBCA) in Cirrhotic Patients. J Clin Exp Hepatol 2022; 12:353-361. [PMID: 35535058 PMCID: PMC9077175 DOI: 10.1016/j.jceh.2021.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 07/27/2021] [Indexed: 12/12/2022] Open
Abstract
Purpose To evaluate the clinical outcomes of transcatheter arterial embolization (TAE) with n-butyl-2-cyanoacrylate (NBCA) for treatment of bleeding in cirrhotic patients. Materials and methods A total of 35 cirrhotic patients (26 men, 9 women; mean age, 48.4 ± 11.1) who underwent TAE with NBCA for bleeding from January 2011 to December 2020 were retrospectively analysed. Only cirrhotic patients with active arterial bleeding confirmed on computed tomography (CT) were included. Fifteen patients were hemodynamically unstable before embolization procedure, and coagulopathy was observed in 32 patients. The mean MELD score and Child Pugh score were 24 ± 9.9 and 9.9 ± 2.2, respectively. The mean haemoglobin level and mean number of RBC units transfused before embolization were 7.4 ± 1.4 g/dL and 10.2 ± 4, respectively. The technical, clinical success rate and 30-day mortality rate were evaluated. Results Technical success and clinical success rates were achieved in 100% and 82.8% of patients, respectively. Overall 30-day mortality rate was 48%. No major complications related to the embolization procedure was seen. Only the greater number of RBC units transfused before the embolization procedure (OR = 1.81, 95% CI = 1.17-2.80, P = 0.007) was significantly associated with clinical failure. Greater number of RBC units transfused (OR = 1.53, 95% CI: 1.00-2.34, P = 0.004) and higher Child Pugh score (OR 2.44, 95% CI 1.26-4.71, P = 0.008) were significantly associated with higher 30-day mortality rate. Conclusion Transcatheter arterial embolization using NBCA can be used as the effective treatment option for bleeding in cirrhotic patients which has a high technical and clinical success despite the grave prognosis associated with cirrhosis.
Collapse
Key Words
- CT, computed tomography
- INR, international normalized ratio
- IQR, Interquartile range
- MELD, model for end-stage liver disease
- NASH, non-alcoholic steatohepatitis
- NBCA
- NBCA, N-butyl-2-cyanoacrylate
- OR, Odds ratio
- PVA, polyvinyl alcohol
- RBC, red blood cell
- TAE, transarterial embolization
- acute arterial bleeding
- cirrhotic patients
- coagulopathy
- transcatheter arterial embolization
Collapse
Affiliation(s)
- Yashwant Patidar
- Department of Interventional Radiology, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi, 110070, India
| | - Shyam V. Srinivasan
- Department of Interventional Radiology, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi, 110070, India
| | - Jitender Singh
- Department of Interventional Radiology, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi, 110070, India
| | - Ranjan K. Patel
- Department of Interventional Radiology, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi, 110070, India
| | - Karamvir Chandel
- Department of Interventional Radiology, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi, 110070, India
| | - Amar Mukund
- Department of Interventional Radiology, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi, 110070, India
| | - Manoj K. Sharma
- Department of Hepatology, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi, 110070, India
| | - Shiv K. Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi, 110070, India
| |
Collapse
|
7
|
Comby PO, Guillen K, Chevallier O, Lenfant M, Pellegrinelli J, Falvo N, Midulla M, Loffroy R. Endovascular Use of Cyanoacrylate-Lipiodol Mixture for Peripheral Embolization: Properties, Techniques, Pitfalls, and Applications. J Clin Med 2021; 10:4320. [PMID: 34640339 PMCID: PMC8509239 DOI: 10.3390/jcm10194320] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/19/2021] [Accepted: 09/20/2021] [Indexed: 12/30/2022] Open
Abstract
Endovascular embolization agents are particles and fluids that can be released into the bloodstream through a catheter to mechanically and/or biologically occlude a target vessel, either temporarily or permanently. Vascular embolization agents are available as solids, liquids, and suspensions. Although liquid adhesives (glues) have been used as embolic agents for decades, experience with them for peripheral applications is generally limited. Cyanoacrylates are the main liquid adhesives used for endovascular interventions and have a major role in managing vascular abnormalities, bleeding, and many vascular diseases. They can only be injected as a mixture with ethiodized oil, which provides radiopacity and modulates the polymerization rate. This review describes the characteristics, properties, mechanisms of action, modalities of use, and indications of the cyanoacrylate-Lipiodol® combination for peripheral embolization.
Collapse
Affiliation(s)
- Pierre-Olivier Comby
- Department of Neuroradiology and Emergency Radiology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (P.-O.C.); (M.L.)
- Imaging and Artificial Vision (ImViA) Laboratory-EA 7535, University of Bourgogne/Franche-Comté, 9 Avenue Alain Savary, BP 47870, 21078 Dijon, France; (K.G.); (O.C.)
| | - Kévin Guillen
- Imaging and Artificial Vision (ImViA) Laboratory-EA 7535, University of Bourgogne/Franche-Comté, 9 Avenue Alain Savary, BP 47870, 21078 Dijon, France; (K.G.); (O.C.)
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (J.P.); (N.F.); (M.M.)
| | - Olivier Chevallier
- Imaging and Artificial Vision (ImViA) Laboratory-EA 7535, University of Bourgogne/Franche-Comté, 9 Avenue Alain Savary, BP 47870, 21078 Dijon, France; (K.G.); (O.C.)
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (J.P.); (N.F.); (M.M.)
| | - Marc Lenfant
- Department of Neuroradiology and Emergency Radiology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (P.-O.C.); (M.L.)
- Imaging and Artificial Vision (ImViA) Laboratory-EA 7535, University of Bourgogne/Franche-Comté, 9 Avenue Alain Savary, BP 47870, 21078 Dijon, France; (K.G.); (O.C.)
| | - Julie Pellegrinelli
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (J.P.); (N.F.); (M.M.)
| | - Nicolas Falvo
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (J.P.); (N.F.); (M.M.)
| | - Marco Midulla
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (J.P.); (N.F.); (M.M.)
| | - Romaric Loffroy
- Imaging and Artificial Vision (ImViA) Laboratory-EA 7535, University of Bourgogne/Franche-Comté, 9 Avenue Alain Savary, BP 47870, 21078 Dijon, France; (K.G.); (O.C.)
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (J.P.); (N.F.); (M.M.)
| |
Collapse
|
8
|
Nakama R, Kadoya T, Kimura T, Arakawa K, Ogura T, Kase K. Transcatheter Arterial Embolization of a Gluteal Pseudoaneurysm Due to Ground-Level Fall in an Elderly Woman Taking Apixaban. INTERVENTIONAL RADIOLOGY 2021; 6:1-3. [PMID: 35910527 PMCID: PMC9327326 DOI: 10.22575/interventionalradiology.2020-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 10/11/2020] [Indexed: 12/05/2022]
Abstract
A 90-year-old woman prescribed with apixaban was admitted to a hospital after a ground-level fall. She was transferred to our hospital for advanced evaluation and treatment. Contrast-enhanced computed tomography showed a pseudoaneurysm inside the right gluteus maximus muscle. Angiography revealed an aneurysm of the peripheral branch of the inferior gluteal artery and multiple slight pseudoaneurysms of the peripheral branch of the internal iliac artery. We performed transcatheter arterial embolization using a gelatin sponge. After embolization, the hemoglobin stabilized. She was transferred to another hospital for rehabilitation. The use of direct oral anticoagulants in the elderly can lead to significant hemorrhage with minimal trauma. Transcatheter arterial embolization is a minimally invasive and safe procedure for such cases of trauma.
Collapse
Affiliation(s)
- Rakuhei Nakama
- Department of Emergency Medicine and Critical Care Medicine, Saiseikai Utsunomiya Hospital
- Department of Radiology, Saiseikai Utsunomiya Hospital
| | - Takashi Kadoya
- Department of Emergency Medicine and Critical Care Medicine, Saiseikai Utsunomiya Hospital
| | - Takuya Kimura
- Department of Emergency Medicine and Critical Care Medicine, Saiseikai Utsunomiya Hospital
| | | | - Takayuki Ogura
- Department of Emergency Medicine and Critical Care Medicine, Saiseikai Utsunomiya Hospital
| | - Kenichi Kase
- Department of Emergency Medicine and Critical Care Medicine, Saiseikai Utsunomiya Hospital
| |
Collapse
|
9
|
Qanadli SD. Reply to the Letter: "Direct Transarterial Embolization with N-Butyl-2-Cyanoacrylate Should be the Choice of Treatment for Spontaneous Hematomas in Patients on Anticoagulation Treatment". Cardiovasc Intervent Radiol 2017; 40:1651-1652. [PMID: 28698992 DOI: 10.1007/s00270-017-1745-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 07/06/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Salah D Qanadli
- Department of Radiology, Cardio-Thoracic and Vascular Unit, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
| |
Collapse
|
10
|
Gordhan A. Intra-operative N-butyl cyanoacrylate embolization arrest of uncontrollable hemorrhage during meningioma resection. J Clin Neurosci 2016; 23:142-5. [PMID: 27088145 DOI: 10.1016/j.jocn.2015.05.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
During the surgical resection of a convexity meningioma in a 63-year-old woman, an uncontrollable active hemorrhage from the operative bed was arrested with microcatheter N-butyl cyanoacrylate (NBCA) embolization after superselective angiography. To date, an uncontrollable neurosurgical intraprocedural hemorrhage terminated by NBCA embolization has not been previously reported. The embolization risk relative to the benefit needs to be carefully considered prior to the surgical removal of a meningioma. This report emphasizes the potential value of embolization with NBCA for arresting active bleeding intraoperatively.
Collapse
|
11
|
Hamaguchi S, Lohman BD, Ogawa Y, Arai Y, Hashimoto K, Matsumoto J, Nakajima Y. Preliminary findings of arterial embolization with balloon-occluded and flow-dependent histoacryl glue embolization in a swine model. Jpn J Radiol 2015; 33:344-51. [PMID: 25935471 DOI: 10.1007/s11604-015-0426-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 04/22/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the potential usefulness of the balloon-occluded histoacryl glue embolization (B-glue) technique. MATERIALS AND METHODS Both flow-dependent (no balloon occlusion) and B-glue techniques were used for 24 intercostal arteries of two female swine. N-butyl 2-cyanoacrylate (NBCA) was diluted with lipiodol to a 50 % solution, which was infused after occluding the arteries with microballoon catheters. The embolization range, fragmentation, reflux, adhesion, and glue particle attachment were compared between flow-dependent and B-glue techniques. RESULTS The B-glue technique was performed in a controlled fashion resulting in successful arterial occlusion without fragmented migration of the injected glue cast. Reflux occurred less frequently with the B-glue technique and was significantly different (p = 0.039) [Corrected] from that for the flow-dependent technique. Catheters were safely removed from the arterial walls, although in one instance (8.3 %), large glue particles were found to be attached to the catheter tip on removal. Conversely, the flow-dependent technique was more difficult to control and resulted in several instances of higher rates of fragmentation. CONCLUSION The B-glue technique can efficiently control NBCA delivery with lower rates of reflux.
Collapse
Affiliation(s)
- Shingo Hamaguchi
- Department of Radiology, St. Marianna University School of Medicine, Sugao 2-16-1, Miyamae-ku, Kawasaki, 216-8511, Japan,
| | | | | | | | | | | | | |
Collapse
|
12
|
Yu PC, Yang TH, Katakwar A, Cheng YJ, Chang PC. Angiographic embolization in chest wall hematoma due to handlebar injury-a rare case report. Am J Emerg Med 2015; 33:1328.e3-5. [PMID: 25782737 DOI: 10.1016/j.ajem.2015.02.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 02/26/2015] [Indexed: 10/23/2022] Open
Affiliation(s)
- Po-Chin Yu
- Division of General Surgery, Department of Surgery, E-DA Hospital/I-Shou University, Kaohsiung City; Department of Traumatology, E-DA Hospital/I-Shou University, Kaohsiung City
| | - Tzu-Hsien Yang
- Department of Radiology, Chang Gung Memorial Hospital, Chiayi, Chiayi County
| | - Abhishek Katakwar
- Bariatric and Metabolic International Surgery Center, E-DA Hospital/I-Shou University, Kaohsiung City, Taiwan
| | - Yu-Jen Cheng
- Division of Thoracic Surgery, Department of Surgery, E-DA Hospital/I-Shou University, Kaohsiung City
| | - Po-Chih Chang
- Division of General Surgery, Department of Surgery, E-DA Hospital/I-Shou University, Kaohsiung City; Bariatric and Metabolic International Surgery Center, E-DA Hospital/I-Shou University, Kaohsiung City, Taiwan.
| |
Collapse
|
13
|
Intra-arterial treatment for subcutaneous or intramuscular bleeding in extremities with arteriovenous fistula. J Vasc Access 2014; 15:546-7. [PMID: 25041918 DOI: 10.5301/jva.5000264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2014] [Indexed: 11/20/2022] Open
|
14
|
Vergaro G, Emdin M, Del Corso A. Correction of procedural arterial pseudoaneurysms: established and novel procedures. Expert Rev Cardiovasc Ther 2014; 12:843-50. [DOI: 10.1586/14779072.2014.923308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
15
|
Development of a canine model with diffuse hepatic vein obstruction (Budd-Chiari syndrome) via endovascular occlusion. Mol Med Rep 2013; 9:607-13. [DOI: 10.3892/mmr.2013.1868] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2013] [Accepted: 11/22/2013] [Indexed: 11/05/2022] Open
|
16
|
Banshodani M, Kawanishi H, Moriishi M, Shintaku S, Sato T, Tsuchiya S. Intra-arterial treatment for massive subcutaneous hemorrhage in hemodialysis patients. Ther Apher Dial 2013; 18:284-90. [PMID: 24118763 DOI: 10.1111/1744-9987.12106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The incidence of acute massive hemorrhage in hemodialysis (HD) patients is thought to be higher than in healthy individuals, and a large, expanding subcutaneous hematoma can result in necrosis of the overlying skin. We evaluated the efficacy of intra-arterial treatment for acute massive subcutaneous hemorrhage in HD patients. Seven HD patients with subcutaneous hemorrhage following minor blunt trauma were treated using superselective transarterial embolization, between July 2005 and October 2012. After examining the site of the hemorrhage using contrast-enhanced computed tomography (CT), embolizations were performed using microcoils, gelatin sponges, or N-butyl cyanoacrylate. Hematoma evacuation or skin grafting was performed as needed. Four men and three women with a mean age of 70 years (range, 63-82 years) comprised the study population. Sites of bleeding were as follows: lower leg (N = 3), upper leg (N = 1), buttock (N = 1), precordia (N = 1), and forearm (N = 1). Blood transfusions were administered to five cases. All patients were successfully salvaged using transarterial embolization. Six patients underwent hematoma evacuation after transarterial embolization, and two patients underwent split-thickness skin grafting for skin necrosis. We established a treatment strategy for HD patients with acute subcutaneous hemorrhage. Immediate confirmation of the site and the degree of bleeding with contrast-enhanced CT and early treatment using the transarterial embolization and as needed, hematoma evacuation are effective for preventing skin necrosis in HD patients with acute subcutaneous hemorrhage.
Collapse
Affiliation(s)
- Masataka Banshodani
- Department of Artificial Organs, Akane-Foundation, Tsuchiya General Hospital, Hiroshima, Japan
| | | | | | | | | | | |
Collapse
|
17
|
A case of pseudoaneurysm of the deep femoral artery successfully treated by NBCA embolization under occlusion. Jpn J Radiol 2013; 31:538-41. [DOI: 10.1007/s11604-013-0207-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 04/08/2013] [Indexed: 10/26/2022]
|
18
|
Zhang GY, Zhou XF, Zhou XY, Wen QY, You BG, Liu Y, Zhang XN, Jin Y. Effect of alginate-chitosan sustained release microcapsules for transhepatic arterial embolization in VX2 rabbit liver cancer model. J Biomed Mater Res A 2013; 101:3192-200. [PMID: 23554214 DOI: 10.1002/jbm.a.34617] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 01/20/2013] [Accepted: 01/22/2013] [Indexed: 11/06/2022]
Abstract
Two lipid-solid dispersion loading Norcantharidin sustained-released microspheres of alginate-chitosan (NCTD/LSD-ACMs) were prepared via the emulsification-gelation method. The effects of microspheres for transarterial hepatic chemoembolization were evaluated in VX2 rabbit liver cancer model. The VX2 animal model was established by biopsy needle, divided randomly into four groups, and disposed with three preparations including NCTD/LSD-ACMs (60-120 μm), NCTD/LSD-ACMs(120-200 μm), and NCTD solution through the hepatic arteries compared with the untreated group (control group). The serum of all rabbits before and at 3, 7, and 14 days after embolization was collected to determine the level of aspartate aminotransferase (AST). The AST level increased in the three treated groups on the first day compared with the control group (p < 0.05), and was higher in the two embolization groups (with no significant difference, p >0.05) than that in the NCTD group (p < 0.05). The tumor growth rates, which were significantly decreased in the two embolization groups compared with that in the control group, and the degree of liver cell necrosis assessed by the histopathological specimens, were used to evaluate the embolization effect. Liquefactive necrosis and coagulative necrosis were observed in the two embolization groups. The results showed that NCTD/LSD-ACMs are a potential candidate for embolization of liver cancer.
Collapse
Affiliation(s)
- Guang-Yu Zhang
- Department of Pharmaceutics, College of Pharmaceutical Sciences, Soochow University, Suzhou, People's Republic of China
| | | | | | | | | | | | | | | |
Collapse
|
19
|
Kim GM, Yoon CJ, Seong NJ, Kang SG, Kim YJ. Postpartum haemorrhage from ruptured pseudoaneurysm: efficacy of transcatheter arterial embolisation using N-butyl-2-cyanoacrylate. Eur Radiol 2013; 23:2344-9. [DOI: 10.1007/s00330-013-2830-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 02/06/2013] [Accepted: 02/27/2013] [Indexed: 11/30/2022]
|