Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital , Dijon, France.
Department of Gastroenterology and Hepatology, Clinical Investigation Center, François-Mitterrand University Hospital , Dijon, France.
Expert Rev Gastroenterol Hepatol. 2020 Oct;14(10):975-984. doi: 10.1080/17474124.2020.1790355. Epub 2020 Jul 22.
Over the past three decades, transcatheter arterial embolization (TAE) has become the first-line therapy for the management of acute nonvariceal gastrointestinal bleeding (NVGIB) that is refractory to endoscopic hemostasis. Advances in catheter-based techniques and newer liquid embolic agents, as well as recognition of the effectiveness of minimally invasive treatment options, have expanded the role of interventional radiology in the treatment of acute NVGIB. Many embolic agents have been used successfully. However, no guidelines exist about the choice of the best embolic agent which is still controversial. Cyanoacrylate glue has gained acceptance over time. This article aims to address the current role of TAE using cyanoacrylate glue for the treatment of acute NVGIB.
The authors undertook a literature review of the current evidence on the use of cyanoacrylate glue in treating patients with acute NVGIB.
The evidence shows that cyanoacrylate glue is the most clinically useful embolic agent in treating patients with acute NVGIB, despite the need for learning curve, especially in case of coagulopathy. At present, research is ongoing to assess liquid embolic agents in the treatment of patients presenting with acute NVGIB. More research is needed but cyanoacrylate glue show promise for the future.
在过去的三十年中,经导管动脉栓塞术(TAE)已成为治疗内镜止血无效的急性非静脉曲张性胃肠道出血(NVGIB)的一线疗法。基于导管的技术和新型液体栓塞剂的进步,以及对微创治疗选择有效性的认识,介入放射学在急性 NVGIB 的治疗中的作用得到了扩展。许多栓塞剂已成功使用。然而,关于最佳栓塞剂选择的指南尚不存在,这仍然存在争议。氰基丙烯酸酯胶已随着时间的推移得到认可。本文旨在探讨使用氰基丙烯酸酯胶进行 TAE 治疗急性 NVGIB 的当前作用。
作者对目前关于使用氰基丙烯酸酯胶治疗急性 NVGIB 患者的证据进行了文献回顾。
证据表明,尽管需要学习曲线,尤其是在存在凝血功能障碍的情况下,氰基丙烯酸酯胶仍然是治疗急性 NVGIB 患者最具临床意义的栓塞剂。目前,正在进行研究以评估液体栓塞剂在治疗急性 NVGIB 患者中的应用。虽然需要进一步研究,但氰基丙烯酸酯胶在未来有很大的应用前景。