Department of Radiology, Majmaah University, Almajmaah, Saudi Arabia.
Department of Radiology, The Tenth People's Hospital, Shanghai, China.
Sci Rep. 2024 Mar 18;14(1):6438. doi: 10.1038/s41598-024-56992-5.
Prophylactic embolization is usually performed using gelatin sponge particles, which are absorbed within several weeks, for managing angiographically negative gastrointestinal bleeding. This study aimed to evaluate the safety and effectiveness of transcatheter arterial embolization (TAE) with quick-soluble gelatin sponge particles (QS-GSP) that dissolve in less than 4 h for treating angiographically negative gastrointestinal bleeding. We included ten patients (M:F = 7:3; mean age, 64.3 years) who underwent prophylactic TAE with QS-GSP for angiographically negative acute gastrointestinal bleeding between 2021 and 2023. The technical success rate of TAE, clinical outcomes focusing on rebleeding, and procedure-related complications were evaluated. The embolized arteries were the gastroduodenal (n = 3), jejunal (n = 4), and ileal (n = 3) arteries. QS-GSP (150-350 µm or 350-560 µm) were used alone (n = 8) or in combination with a coil (n = 1). A 100% technical success rate was accomplished. In 1 patient (10%), rebleeding occurred 2 days after prophylactic TAE of the gastroduodenal artery, and this was managed by repeat TAE. There were no procedure-related complications. The use of QS-GSP for prophylactic TAE appears to be safe and effective for controlling bleeding among patients with angiographically negative gastrointestinal bleeding. There were no cases of related ischemic complications of the embolized bowels likely attributable to recanalization of the affected arteries following biodegradation of QS-GSP.
预防性栓塞通常使用明胶海绵颗粒进行,这些颗粒在数周内被吸收,用于治疗血管造影阴性的胃肠道出血。本研究旨在评估快速溶解明胶海绵颗粒(QS-GSP)经导管动脉栓塞(TAE)治疗血管造影阴性胃肠道出血的安全性和有效性,QS-GSP 在不到 4 小时内溶解。我们纳入了 2021 年至 2023 年期间因血管造影阴性急性胃肠道出血而行预防性 TAE 用 QS-GSP 的 10 例患者(男/女=7/3;平均年龄 64.3 岁)。评估了 TAE 的技术成功率、以再出血为重点的临床结果和与操作相关的并发症。栓塞的动脉包括胃十二指肠动脉(n=3)、空肠动脉(n=4)和回肠动脉(n=3)。QS-GSP(150-350µm 或 350-560µm)单独使用(n=8)或与线圈联合使用(n=1)。100%的技术成功率得以实现。1 例(10%)患者在胃十二指肠动脉预防性 TAE 后 2 天发生再出血,再次 TAE 后得到控制。无操作相关并发症。对于血管造影阴性胃肠道出血患者,QS-GSP 用于预防性 TAE 似乎是安全有效的,可以控制出血。栓塞肠段无缺血性并发症,可能归因于 QS-GSP 生物降解后受影响的动脉再通。