Transcatheter Arterial Embolization Treatment for Bleeding Visceral Artery Pseudoaneurysms in Patients with Pancreatitis or following Pancreatic Surgery

Abstract

Purpose: To evaluate the efficacy and safety of transcatheter arterial embolization (TAE) for pseudoaneurysms occurring secondary to pancreatitis or because of leakage of pancreatic juice after pancreatectomy. Materials and Methods: This retrospective study included 42 consecutive patients (38 males and 4 females; mean age, 60 years; range, 33–80 years) who underwent TAE for bleeding visceral artery pseudoaneurysms between March 2004 and December 2018. The technical and clinical success rates, incidence of recurrent bleeding, complications, including pancreatitis, and overall survival after TAE were evaluated. Results: Of the 42 enrolled patients, 23 had bleeding due to a complication of pancreatectomy and 19 had bleeding as a complication of pancreatitis. TAE with N-butyl cyanoacrylate (NBCA) or NBCA plus microcoils recurrent bleeding or inability to control bleeding was 15.8% (3 of 19) following TAE with NBCA and 17.4% (4 of 23) following TAE with coils. No clinically significant ischemic events of the pancreas or duodenum were observed in the embolized areas. Serum amylase did not increase compared with the initial levels after any of the procedures. At 30 days after TAE, 32 patients were alive. Conclusion: TAE has a high success rate for the management of hemorrhage, with few complications. The procedure appears to be safe and effective for pseudoaneurysms associated with either pancreatitis or pancreatectomy.

Emodin inhibits the progression of acute pancreatitis via regulation of lncRNA TUG1 and exosomal lncRNA TUG1

“…Acute pancreatitis (AP) is a type of inflammatory disease, which results from the dysregulation of pancreatic enzymes in the pancreas (1,2). AP is very common, has a considerably high mortality rate and can cause systemic complications (3).…”

Transcatheter Arterial Embolization in Acute Non-Variceal Gastrointestinal Bleedings: A Ten-Year Single-Center Experience in 91 Patients and Review of the Literature

“…According to standards of practice guidelines of the Society of Interventional Radiology [ 19 ], major complications were defined and classified as follows. Grade 1: complications that require therapy and minor hospitalization (<48 h); grade 2: complications that require major therapy, unplanned increase in level of care, and prolonged hospitalization (>48 h); grade 3: complications that require permanent adverse sequelae; grade 4: death.…”

“…Several studies have recently shown the safety and efficacy of TAE with the use of advanced tools and techniques for UGIB and LGIB, but to our knowledge, most of them have included a limited number of patients [ 2 , 4 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. Coil embolization is the most used technique worldwide to treat GIB, avoiding bowel ischemic complications [ 2 , 4 ].…”

Major and minor complications of the pancreas after transcatheter arterial embolization using n-butyl-2-cyanoacrylate for acute bleeding from pancreatic arteries

“…In contrast, with embolization using NBCA for pancreas, there are concerns about pancreatic complications such as pancreatitis [12], although a few retrospective studies showed that TAE with NBCA for the pancreas was a safe treatment with no serious complications [7,13]. Mild pancreatitis or serum amylase elevation sometimes occurred after TAE clinically and an animal experiment showed that selective TAE with NBCA in the pancreas caused localized ischemic necrosis without clinically significant pancreatitis [14].…”