N-butyl cyanoacrylate embolization for control of acute arterial hemorrhage.
OBJECTIVE
To report the initial clinical experience with the use of n-butyl cyanoacrylate (NBCA) for embolization of acute arterial hemorrhage from varied etiologies and at varied anatomic sites.


METHODS
Sixteen patients who demonstrated active extravasation of contrast material and/or arterial abnormality underwent NBCA embolization. Sites of embolization included the gastrointestinal tract, kidney, liver, uterus, adrenal gland, extremity, and chest wall. Standard coil or particulate embolization had previously failed in 10 patients. NBCA was used as the initial embolic agent in the remaining six patients. After treatment, serial hematocrit levels, transfusion requirements, and clinical signs and symptoms were monitored for stabilization. Patients were evaluated for signs and symptoms of end-organ damage.


RESULTS
NBCA embolization was successful in 12 of 16 patients (75%), who exhibited complete cessation of bleeding. In four patients (25%), NBCA embolization was of no benefit. Embolization failed in two of 16 patients (12.5%), who showed evidence of recurrent bleeding after use of NBCA. The remaining two patients (12.5%) died within 24 hours of the procedure. None of the 16 patients developed clinical signs of end-organ damage or iatrogenic ischemia attributable to NBCA.


CONCLUSIONS
In this initial limited series, NBCA embolization was shown to be a feasible and effective method to control acute arterial hemorrhage. NBCA embolization was able to stop arterial bleeding even when previous coil or particulate embolization had failed.
Kish
John William
JW
Department of Radiology, Los Angeles County and University of Southern California Medical Center, 90064, USA.
Katz
Michael D
MD
Marx
M Victoria
MV
Harrell
Donald S
DS
Hanks
Sue E
SE
D000208:Acute Disease; D000328:Adult; D000368:Aged; D001158:Arteries; D003487:Cyanoacrylates / Q000627:therapeutic use*; D004621:Embolization, Therapeutic / Q000379:methods*; D005119:Extravasation of Diagnostic and Therapeutic Materials; D005260:Female; D006470:Hemorrhage / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome
D003487:Cyanoacrylates; D014014:Tissue Adhesives