Hepatic infarction following selective hepatic artery embolization with microcoils for iatrogenic biliary hemorrhage

Hashimoto, Manabu; Akabane, Yoko; Heianna, Joichi; Tate, Etsuko; Ishiyama, Koichi; Nishii, Toshiaki; Watarai, Jiro

doi:10.1016/j.hepres.2004.05.002

Cited by 12 publications

(12 citation statements)

References 21 publications

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“…The reported success of coil embolization for hemobilia ranges from 75-100%. [3,[16][17][18][19] The technical success and clinical success was 100% and 91.7% in the present study, which are comparable to previous studies. No recurrent hemobilia or bleeding was noted during the follow-up, which demonstrated the durability of NBCA embolization.…”

Section: Discussionsupporting

confidence: 91%

“…According to available evidence, coil embolization is associated with high success and fewer complications. [3,[16][17][18][19] However, there are several limitations to coil embolization. First, catheterization into the target vessel complicated by extremely tortuous or narrow vascular anatomy may be di cult, thus resulting in failed coil embolization.…”

Section: Discussionmentioning

confidence: 99%

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Transcatheter arterial embolization for massive hemobilia with N-butyl cyanoacrylate (NBCA) Glubran 2

et al. 2021

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Background Massive hemobilia is a life-threatening condition and therapeutic challenge. Few studies have demonstrated the use of N-butyl cyanoacrylate (NBCA) for massive hemobilia. Purpose To investigate the efficacy and safety of transcatheter arterial embolization (TAE) using NBCA Glubran 2 for massive hemobilia. Material and Methods Between January 2012 and December 2019, the data of 26 patients (mean age 63.4 ± 12.6 years) with massive hemobilia were retrospectively evaluated for TAE using NBCA. The patients’ baseline characteristics, severities of hemobilia, and imaging findings were collected. Emergent TAE was performed using 1:2–1:4 mixtures of NBCA and ethiodized oil. Technical success, clinical success, procedure-related complications, and follow-up outcomes were assessed. Results Pre-procedure arteriography demonstrated injuries to the right hepatic artery (n = 24) and cystic artery (n = 2). Initial coil embolization distal to the lesions was required in 5 (19.2%) patients to control high blood flow and prevent end-organ damage. After a mean treatment time of 11.2 ± 5.3 min, technical success was achieved in 100% of the patients without non-target embolization and catheter adhesion. Clinical success was achieved in 25 (96.2%) patients. Major complications were noted in 1 (3.8%) patient with gallbladder necrosis. During a median follow-up time of 16.5 months (range 3–24 months), two patients died due to carcinomas, whereas none of the patients experienced recurrent hemobilia, embolic material migration, or post-embolization complications. Conclusion NBCA embolization for massive hemobilia is associated with rapid and effective hemostasis, as well as few major complications. This treatment modality may be a promising alternative to coil embolization.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Transcatheter arterial embolization for massive hemobilia with N-butyl cyanoacrylate (NBCA) Glubran 2

et al. 2021

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“…17,18,33 If stent-graft implantation is difficult due to anatomical reasons, such as tortuosity or variation, embolization can also be considered in patients with splenic artery pseudoaneurysms. However, embolization of the common or proper hepatic artery should be restricted to patients with collateral hepatic blood flow, 14,34 such as a right subphrenic artery (Fig. 3b) or a replaced hepatic artery (Fig.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Management of Hemorrhage from Visceral Artery Pseudoaneurysms after Pancreatic Surgery

Ding

Zhu

et al. 2011

Journal of Gastrointestinal Surgery

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“…In fact, the procedure, although safer than surgery, is not without risk. Hepatobiliary necrosis (6%), abscess formation (9%), bleeding (6%) and gallbladder fibrosis (2%) have occurred following arterial embolisation14 and sometimes are related to incorrect selection of embolic agents and inappropriate use of superselective technique 17. Surgery is indicated when TAE has failed, in cases of hepatic sepsis or haemobilia associated with cholelithiasis, cholecystitis or resectable neoplasms 14.…”

Section: Discussionmentioning

confidence: 99%

Haemobilia due to hepatic artery pseudoaneurysm

Teixeira¹,

Ribeiro

Alves

et al. 2017

BMJ Case Reports

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An 83-year-old woman with a history of hepaticoduodenostomy 20 years ago was admitted with upper gastrointestinal bleeding. Emergency upper gastrointestinal endoscopy revealed multiple blood clots over the stomach and first and second parts of the duodenum. The cannulation of the biliary tree with a flexible end-viewing endoscope exposed the presence of blood clot inside biliary lumen and a semipedunculated polyp which, at first, appeared to be the cause of haemorrhage. A few days after polypectomy, patient was discharged home, however, was admitted again with massive bleeding and selective angiography demonstrated a pseudoaneurysm of left hepatic artery. Angioembolisation was performed and haemorrhage was stopped afterwards.

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Hepatic infarction following selective hepatic artery embolization with microcoils for iatrogenic biliary hemorrhage

Cited by 12 publications

References 21 publications

Transcatheter arterial embolization for massive hemobilia with N-butyl cyanoacrylate (NBCA) Glubran 2

Transcatheter arterial embolization for massive hemobilia with N-butyl cyanoacrylate (NBCA) Glubran 2

Therapeutic Management of Hemorrhage from Visceral Artery Pseudoaneurysms after Pancreatic Surgery

Haemobilia due to hepatic artery pseudoaneurysm

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