Radiology Unit, Pugliese-Ciaccio Hospital, 88100 Catanzaro, Italy.
Diagnostic and Interventional Radiology Unit, ASST Settelaghi, Insubria University, Varese 21100, Italy.
Medicina (Kaunas). 2023 Apr 4;59(4):710. doi: 10.3390/medicina59040710.
Transcatheter arterial embolization (TAE) is part of the daily practice of most interventional radiologists worldwide. The ideal liquid embolic agent is far from being identified. Non-adhesive liquid embolic agents (NALEA) harden from the outside to the inside, resulting in deep penetration, known as "magma-like" progression, which permits a more distal embolization with good control of the embolic material. This multicenter retrospective cohort study aims to assess the efficacy, feasibility and safety of transcatheter arterial embolization (TAE) with ethylene-vinyl alcohol (EVOH)-based NALEAs (Onyx and Squid) in acute bleeding outside of the neurovascular area. This study is a multicenter analysis of retrospectively collected data of consecutive patients who had undergone, from January 2015 to December 2022, transcatheter arterial embolization with non-adhesive EVOH-based agents in the setting of acute non-neurovascular bleeding. Fifty-three patients underwent transcatheter arterial embolization for acute non-neurovascular bleeding. Eight (15.1%) procedures were performed in patients with coagulopathy. The most used concentration of EVOH-based NALEAs was 34 (i.e., 8%), with a mean dose of 0.5 (±0.3) mL. The mean CT-to-groin time, the mean procedure time, the mean CT-to-embolization time and the mean fluoroscopy time were 22.9 (±12.4) min, 27.5 (±7) min, 50.3 (±13.1) min and 7.5 (±2.8) min, respectively. Technical success was achieved in all cases with a 96.2% clinical success rate. Complications were recorded in six (11.3%) patients. No statistically significant differences were observed between the group of patients with coagulopathy and the group of patients without coagulopathy in terms of efficacy and safety endpoints. Transcatheter arterial embolization (TAE) performed with non-adhesive EVOH-based embolic agents is an effective, feasible and safe strategy for the management of acute non-neurovascular bleeding, even in the subgroup of patients with coagulopathy.
经导管动脉栓塞术（TAE）是世界范围内大多数介入放射科医生日常实践的一部分。理想的液体栓塞剂还远未被确定。非粘性液体栓塞剂（NALEA）从外到内变硬，导致深穿透，称为“岩浆样”进展，允许更远端的栓塞，并很好地控制栓塞材料。这项多中心回顾性队列研究旨在评估经导管动脉栓塞术（TAE）用乙烯-乙烯醇（EVOH）为基础的 NALEA（Onyx 和 Squid）治疗非神经血管区域急性出血的疗效、可行性和安全性。这项研究是对 2015 年 1 月至 2022 年 12 月期间接受非粘性 EVOH 为基础的制剂经导管动脉栓塞术治疗急性非神经血管出血的连续患者进行的多中心回顾性数据分析。53 例患者因急性非神经血管出血而行经导管动脉栓塞术。8 例（15.1%）手术在凝血障碍患者中进行。最常用的 EVOH 为基础的 NALEA 浓度为 34（即 8%），平均剂量为 0.5（±0.3）mL。CT 至腹股沟时间、手术时间、CT 至栓塞时间和透视时间的平均值分别为 22.9（±12.4）min、27.5（±7）min、50.3（±13.1）min 和 7.5（±2.8）min。所有病例均获得技术成功，临床成功率为 96.2%。6 例（11.3%）患者发生并发症。在疗效和安全性终点方面，凝血障碍组和无凝血障碍组之间无统计学差异。使用非粘性 EVOH 为基础的栓塞剂进行经导管动脉栓塞术（TAE）是治疗急性非神经血管出血的有效、可行和安全的策略，即使在凝血障碍患者亚组中也是如此。
