Majdalany Bill S, Khaja Minhaj S, Sanogo Mamadou L, Saad Wael E
Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan, USA.
Diagn Interv Radiol. 2018 Nov;24(6):385-387. doi: 10.5152/dir.2018.18181.
N-butyl cyanoacrylate glue is well established as a transcatheter or direct injection embolic agent. Herein, targeted glue embolization was performed by direct needle injection into peripheral portal branches and along the surface of the liver to directly treat actively extravasating portal venous injury. In both cases, hemodynamically unstable patients underwent exploratory laparotomy, which was not able to definitively treat the hemorrhage. Subsequently, emergent visceral angiography and indirect portography revealed active portal phase extravasation. Transhepatic direct needle injection of the peripheral portal active extravasation with glue was successful in both cases and the patients stabilized, demonstrating this as an efficacious salvage approach.
氰基丙烯酸正丁酯胶水作为一种经导管或直接注射的栓塞剂已得到广泛应用。在此，通过直接经皮穿刺将胶水注射到肝外周门静脉分支及沿肝脏表面进行靶向胶水栓塞，以直接治疗门静脉活动性出血。在这两例病例中，血流动力学不稳定的患者均接受了剖腹探查术，但未能彻底治疗出血。随后，急诊内脏血管造影和间接门静脉造影显示门静脉期有活动性外渗。两例病例中经皮肝穿刺直接将胶水注射到门静脉外周活动性外渗部位均获成功，患者病情稳定，表明这是一种有效的挽救方法。
