Kwon Jae Hyun, Han Yoon Hee
Department of Radiology, Dongguk University Ilsan Hospital, Dongguk University Graduate School of Medicine, 27 Dongguk-ro, Siksa-dong, Ilsandong-gu, Gyeonggi-do, Goyang, 10326, South Korea.
Emerg Radiol. 2018 Apr;25(2):111-120. doi: 10.1007/s10140-017-1552-0. Epub 2017 Oct 2.
To evaluate the efficacy and safety of superselective trans-catheter arterial embolization (TAE) with N-butyl-2-cyanoacrylate (NBCA) for patients with acute non-variceal upper and lower gastrointestinal (GI) bleeding.
TAE using NBCA was performed in 21 patients (13 males, 8 females, mean age 60.9 years) with acute non-variceal upper (n = 15) and lower (n = 6) GI bleeding. TAE using other embolic agents was performed in 25 patients (13 males, 12 females, mean age 69.1 years) with acute non-variceal upper (n = 16) and lower (n = 9) GI bleeding. Technical success, clinical success, clinical failure, major and minor complications, bleeding-related 30-day mortality, and overall in-hospital mortality were analyzed.
In 21 patients who underwent TAE with NBCA, the overall technical success was 100% (21/21) and overall clinical success was 72.2% (13/18). Uncontrolled bleeding, recurrent bleeding, and clinical failure were seen in 11.1% (2/18), 16.7% (3/18), and 27.8% (5/18) of cases, respectively. The minor complication rate was 16.7% (4/21) and no major complications occurred. Three patients showed ischemic damage in the treated lesion and one patient showed epigastric pain. The bleeding-related 30-day mortality and overall in-hospital mortality rates were 16.7% (3/18) and 28.6% (6/21), respectively. Two patients died of septic shock and one died of myocardial infarction within 30 days after TAE. In 25 patients who underwent TAE with other agents, the overall technical success was 100% (25/25), and the overall clinical success was 68.2% (15/22). The rates of uncontrolled bleeding, recurrent bleeding, clinical failure, bleeding-related 30-day mortality, and overall in-hospital mortality were 0.5% (1/22), 22.7% (5/22), 31.8% (7/22), 22.7% (5/22), and 32.0% (8/25), respectively.
TAE with NBCA for acute non-variceal upper and lower GI bleeding proved to be a technically feasible, safe, and effective treatment modality. Thus, NBCA could be used as a primary embolic agent for controlling GI bleeding.
评估使用N-丁基-2-氰基丙烯酸酯（NBCA）进行超选择性经导管动脉栓塞术（TAE）治疗急性非静脉曲张性上、下消化道（GI）出血患者的疗效和安全性。
对21例（13例男性，8例女性，平均年龄60.9岁）急性非静脉曲张性上消化道出血（n = 15）和下消化道出血（n = 6）患者采用NBCA进行TAE治疗。对25例（13例男性，12例女性，平均年龄69.1岁）急性非静脉曲张性上消化道出血（n = 16）和下消化道出血（n = 9）患者采用其他栓塞剂进行TAE治疗。分析技术成功率、临床成功率、临床失败率、主要和次要并发症、出血相关30天死亡率及总体住院死亡率。
在21例接受NBCA TAE治疗的患者中，总体技术成功率为100%（21/21），总体临床成功率为72.2%（13/18）。分别有11.1%（2/18）、16.7%（3/18）和27.8%（5/18）的病例出现出血未控制、再出血和临床失败。次要并发症发生率为16.7%（4/21），未发生主要并发症。3例患者治疗病变出现缺血性损伤，1例患者出现上腹部疼痛。出血相关30天死亡率和总体住院死亡率分别为16.7%（3/18）和28.6%（6/21）。2例患者在TAE后30天内死于感染性休克，1例死于心肌梗死。在25例接受其他栓塞剂TAE治疗的患者中，总体技术成功率为100%（25/25），总体临床成功率为68.2%（15/22）。出血未控制、再出血、临床失败、出血相关30天死亡率和总体住院死亡率分别为0.5%（1/22）、22.7%（5/22）、31.8%（7/22）、22.7%（5/22）和32.0%（8/25）。
使用NBCA进行TAE治疗急性非静脉曲张性上、下消化道出血在技术上是可行、安全且有效的治疗方式。因此，NBCA可作为控制消化道出血的主要栓塞剂。
