Enhancing Outcomes in Transarterial Embolization for Late Postpancreatectomy Hemorrhage: A Comparison of N-Butyl Cyanoacrylate with Mixed Embolic Agents Versus Mixed Embolic Agents Alone.

BACKGROUND

This study aimed to retrospectively compare the efficacy of transarterial embolization (TAE) with N-butyl cyanoacrylate (NBCA) and conventional agents (microcoils, polyvinyl alcohol [PVA], or gelatin sponge) in the treatment of patients with late postpancreatectomy hemorrhage (late-PPH).

METHODS

From June 2012 to June 2022, this retrospective study enrolled 130 consecutive patients who underwent TAE treatment due to late-PPH at one institution. Of these patients, 56 were treated with NBCA-mixed conventional agents (NBCA-MA group), and 74 were treated with mixed conventional agents alone (MA group). The patients' clinical characteristics and TAE details were gathered. The clinical outcomes in the two groups were compared. Using univariate and multivariate logistic regression analyses, prognostic factors were evaluated for clinical success and 30-day mortality rates.

RESULTS

The clinical success in the NBCA-MA group was 80.4% higher than that in the MA group (60.8%). Rebleeding was significantly more common in the MA group (29.7% vs. 8.9%). The 30-day mortality rate of the NBCA-MA group was lower than that of the MA group (16.1% vs. 33.8%). NBCA use was a significant prognostic factor associated with clinical success, while age and NBCA use were significant factors associated with the 30-day mortality rate.

CONCLUSION

In conclusion, we found that TAE with NBCA is a safe and effective method for treating late-PPH.