Transcatheter arterial embolization of arterial esophageal bleeding with the use of N-butyl cyanoacrylate.
OBJECTIVE
To evaluate the clinical efficacy and safety of a transcatheter arterial embolization (TAE) with N-butyl cyanoacrylate (NBCA) for the treatment of arterial esophageal bleeding.


METHODS
Between August 2000 and April 2008, five patients diagnosed with arterial esophageal bleeding by conventional angiography, CT-angiography or endoscopy, underwent a TAE with NBCA. We mixed NBCA with iodized oil at ratios of 1:1 to 1:4 to supply radiopacity and achieve a proper polymerization time. After embolization, we evaluated the angiographic and clinical success, recurrent bleeding, and procedure-related complications.


RESULTS
The bleeding esophageal artery directly originated from the aorta in four patients and from the left inferior phrenic artery in one patient. Although four patients had an underlying coagulopathy at the time of the TAE, angiographic and clinical success was achieved in all five patients. In addition, no procedure-related complications such as esophageal infarction were observed during this study.


CONCLUSIONS
NBCA can be an effective and feasible embolic agent in patients with active arterial esophageal bleeding, even with pre-existing coagulopathy.
Park
Ji Hoon
JH
Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
Kim
Hyo-Cheol
HC
Chung
Jin Wook
JW
Jae
Hwan Jun
HJ
Park
Jae Hyung
JH
D000328:Adult; D000368:Aged; D000792:Angiography; D001158:Arteries; D002404:Catheterization; D004621:Embolization, Therapeutic / Q000379:methods*; D004659:Enbucrilate / Q000008:administration & dosage / Q000627:therapeutic use*; D004935:Esophageal Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged
D004659:Enbucrilate