Department of Radiology and Center for Endovascular Therapy, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Japan.
J Vasc Interv Radiol. 2011 Mar;22(3):302-8. doi: 10.1016/j.jvir.2010.11.011.
To evaluate the clinical effectiveness and safety of transcatheter arterial embolization with n-butyl cyanoacrylate (NBCA) for pseudoaneurysms complicating pancreatitis or pancreatectomy.
Twelve procedures were performed in nine patients (seven men and two women; mean age, 60.6 years) for pseudoaneurysms that occurred secondary to pancreatitis or as a consequence of pancreatic juice leakage at the site of pancreatectomy. For embolization, NBCA was mixed with iodized oil at a ratio of 1:1-1:4; in one patient with failed selective catheterization of the target vessel, the mixture ratio was 1:9. Technical and clinical success rates, recurrent bleeding, procedural complications, serum amylase level, and clinical outcome were determined for each procedure.
Embolization was technically successful in all procedures, with no recurrent bleeding documented from the initially treated territory. In three procedures, we encountered additional bleeding vessels at 11, 33, and 49 days after the procedures, which were successfully managed by a second embolization in each case. There were no major complications related to the procedures. As minor complications, in two procedures, the embolized material overflowed beyond the target vessels; however, no clinically significant ischemic events were observed in the embolized territories. Serum amylase did not increase compared with initial levels after any of the procedures. Seven patients were discharged after clinical improvement. Two patients died 2 and 3 weeks after the embolization as a result of multiple organ failure not associated with the procedure.
In this limited series, NBCA embolization was found to be feasible and effective for pseudoaneurysms as a complication of pancreatitis or pancreatectomy.
评估经导管动脉内应用 n-丁基氰基丙烯酸酯（NBCA）栓塞治疗胰腺炎或胰腺切除术后假性动脉瘤的临床疗效和安全性。
9 例患者（7 例男性，2 例女性；平均年龄 60.6 岁）共 12 例次接受治疗，这些假性动脉瘤继发于胰腺炎或胰腺切除术后胰液漏至手术部位。NBCA 与碘油按 1:1-1:4 混合（1 例患者因目标血管选择性插管失败，混合比例为 1:9）用于栓塞。评估了每例次治疗的技术和临床成功率、再出血、操作并发症、血清淀粉酶水平和临床转归。
所有治疗均达到技术成功，未发现最初治疗区域有再出血。在 3 例次中，我们在术后 11、33 和 49 天发现了额外的出血血管，这 3 例次均通过再次栓塞成功处理。无与操作相关的重大并发症。2 例次出现轻微并发症，栓塞材料溢出至目标血管以外，但栓塞区域未观察到有临床意义的缺血事件。与操作前相比，任何操作后血清淀粉酶均无明显升高。7 例患者在临床改善后出院。2 例患者在栓塞后 2 周和 3 周因与操作无关的多器官功能衰竭死亡。
在这项有限系列研究中，我们发现 NBCA 栓塞治疗胰腺炎或胰腺切除术后假性动脉瘤是可行且有效的。
