title: N-butyl cyanoacrylate embolization for pseudoaneurysms complicating pancreatitis or pancreatectomy.
abstract: OBJECTIVE
  To evaluate the clinical effectiveness and safety of transcatheter arterial embolization with n-butyl cyanoacrylate (NBCA) for pseudoaneurysms complicating pancreatitis or pancreatectomy.
  
  
  METHODS
  Twelve procedures were performed in nine patients (seven men and two women; mean age, 60.6 years) for pseudoaneurysms that occurred secondary to pancreatitis or as a consequence of pancreatic juice leakage at the site of pancreatectomy. For embolization, NBCA was mixed with iodized oil at a ratio of 1:1-1:4; in one patient with failed selective catheterization of the target vessel, the mixture ratio was 1:9. Technical and clinical success rates, recurrent bleeding, procedural complications, serum amylase level, and clinical outcome were determined for each procedure.
  
  
  RESULTS
  Embolization was technically successful in all procedures, with no recurrent bleeding documented from the initially treated territory. In three procedures, we encountered additional bleeding vessels at 11, 33, and 49 days after the procedures, which were successfully managed by a second embolization in each case. There were no major complications related to the procedures. As minor complications, in two procedures, the embolized material overflowed beyond the target vessels; however, no clinically significant ischemic events were observed in the embolized territories. Serum amylase did not increase compared with initial levels after any of the procedures. Seven patients were discharged after clinical improvement. Two patients died 2 and 3 weeks after the embolization as a result of multiple organ failure not associated with the procedure.
  
  
  CONCLUSIONS
  In this limited series, NBCA embolization was found to be feasible and effective for pseudoaneurysms as a complication of pancreatitis or pancreatectomy.
authors.affiliation: Department of Radiology and Center for Endovascular Therapy, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Japan. izaki@med.kobe-u.ac.jp
authors.forename: Kenta
authors.initials: K
authors.lastname: Izaki
authors.forename: Masato
authors.initials: M
authors.lastname: Yamaguchi
authors.forename: Ryota
authors.initials: R
authors.lastname: Kawasaki
authors.forename: Takuya
authors.initials: T
authors.lastname: Okada
authors.forename: Kazuro
authors.initials: K
authors.lastname: Sugimura
authors.forename: Koji
authors.initials: K
authors.lastname: Sugimoto
mesh_terms: D000328:Adult; D000368:Aged; D000681:Amylases / Q000097:blood; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D004659:Enbucrilate / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007459:Iodized Oil / Q000627:therapeutic use; D007564:Japan; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D010195:Pancreatitis / Q000150:complications*; D019106:Postoperative Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D011859:Radiography; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D007459:Iodized Oil; D000681:Amylases; D004659:Enbucrilate