Superselective arterial embolisation with a liquid polyvinyl alcohol copolymer in patients with acute gastrointestinal haemorrhage

Abstract

The copolymer seems to have great potential in embolotherapy of acute arterial gastrointestinal bleeding. In our series none of the patients had rebleeding at the site of embolisation and no clinically obvious bowel necrosis occurred.

Transcatheter arterial embolisation in upper gastrointestinal bleeding in a sample of 29 patients in a gastrointestinal referral center in Germany

“…At first sight, it may seem surprising that a superselective exploration and embolization of the bleeding sites resulted in the most, i.e., 5, treatment failures. However, this is not only consistent with the relevant literature [27], but also explained by the fact that these cases frequently involve several microscopic bleeding sites which, sometimes, cannot be superselectively managed. Moreover, rebleeding rates are, in general, higher in TAE treated patients than in patients having undergone surgery [25,26].…”

Liquid Embolization with Onyx in a Technically Challenging Case of Acute Upper GI Bleeding

“…However, the use of Onyx as embolizing agent for bleeding from peptic ulcer has not found widespread use, and literature on this topic has been sparse at best. Lenhart et al [3] mentioned two cases of peptic ulcer bleeding (one gastric ulcer and one duodenal ulcer) treated with Onyx, showing good result in long-term follow-up (about 2 years). In our case too, we have obtained satisfactory result after Onyx embolization of a difficult-to-approach lesion of bleeding duodenal ulcer.…”

“…Gelatin sponge was avoided, as it causes only temporary embolization. It was then decided to use the liquid embolizing material Onyx (EV3 Neurovascular, Irvine, CA, USA) because of its easy controllability during injection, nonadhesive nature, lava-like casting, and no necessity of crossing the bleeding point [3]. A microcatheter was primed with dimethyl sulfoxide (DMSO), and then, Onyx 18 (6 % ethylene vinyl alcohol [EVOH]) was injected at a very slow pace.…”

“…Various embolizing materials (such as coils, gelatin sponge, PVA particles, microspheres, etc.) and embolization techniques have been employed to achieve sufficient hemostasis, though the most widely used technique for achieving hemostasis is endovascular coiling [2,3]. However, use of the liquid embolizing material Onyx for bleeding peptic ulcer has not found widespread application, and literature on the topic has been sparse.…”

Letter to the Editor re: Superselective arterial embolisation with a liquid polyvinyl alcohol copolymer in patients with acute gastrointestinal haemorrhage

“…We read with great interest the article by Lenhart and colleagues recently published in European Radiology and reporting effectiveness of selective arterial embolisation using Onyx® in patients with acute gastrointestinal bleeding [1]. We have several comments.…”