Ethylene-vinyl alcohol polymer trans-arterial embolization in emergency peripheral active bleeding: initial experience.

Abstract

AIM:

The aim of this paper was to evaluate the efficacy, safety, and clinical outcomes of superselective embolization using ethylene-vinyl alcohol copolymer (Onyx Liquid Embolic System; ev3 Neurovascular, Irvine, CA, USA) as the primary treatment in active peripheral emergency arterial bleeding.

METHODS:

Between January 2014 and June 2014, all patients with active peripheral arterial bleeding who were treated by embolization were retrospectively analyzed. We selected 15 (age 37-91 year old) patients embolized with Onyx, chosen as embolic agent in an intention-to-treat fashion. Multidetector computed tomography was performed in all patients.

RESULTS:

Active bleeding was detected in all cases. Digital subtraction angiography confirmed CT findings in all cases. The causes of bleeding were traumatic in 8 patients, angiodysplasia in 1 patient, duodenal ulcer in 1, chronic pancreatitis in 1 and unknown in 4 patients. Nine patients were under anticoagulant or antiplatelet therapy. Embolization was possible in all patients. The technical success rate was 100%. The immediate bleeding control rate was 100%. No rebleeding at 30 days occurred (0%). There were no major complications, or deaths attributable to the treatment. No patient needed surgery or new embolization during a mean follow-up period of 5.1 months (range, 4.5-6 months).

CONCLUSION:

Control of massive active peripheral emergency arterial bleeding using superselective embolization with Onyx is feasible and safe.

• Authors: A M Ierardi, G Xhepa, E Duka, D Laganà, A Ianniello, C Floridi, A Bacuzzi, A Reginelli, E Squillaci, L Brunese, G Carrafiello
• Journal: International angiology : a journal of the International Union of Angiology (Int Angiol) Vol. 34 Issue 6 Suppl 1 Pg. 28-35 (Dec 2015) ISSN: 1827-1839 [Electronic] Italy
• PMID: 26498889 (Publication Type: Journal Article)

Chemical References

• Polyvinyls
• ethylene-vinyl alcohol copolymer

Topics

• Adult
• Aged
• Aged, 80 and over
• Angiography, Digital Subtraction
• Embolization, Therapeutic (methods)
• Emergencies
• Female
• Hemorrhage (therapy)
• Humans
• Male
• Middle Aged
• Multidetector Computed Tomography
• Peripheral Arterial Disease (therapy)
• Polyvinyls (therapeutic use)
• Retrospective Studies
• Treatment Outcome