title: Recanalization after successful occlusion by transcatheter arterial embolization with N-butyl cyanoacrylate for traumatic splenic artery injury.
abstract: A 70-year-old male with advanced pancreatic cancer went into shock after sustaining a traumatic abdominal injury. Computed tomography (CT) showed a hematoma with extravasation around the pancreas and hemorrhagic ascites. After direct catheterization failed due to angiospasm, the ruptured splenic artery was successfully occluded by transcatheter arterial embolization (TAE) using an N-butyl cyanoacrylate (NBCA)-lipiodol mixture and the patient recovered from shock without complications. A follow-up CT obtained 20 days later showed a recurrent splenic artery pseudoaneurysm without extravasation. A repeat angiogram demonstrated recanalization of the splenic artery and pseudoaneurysm via antegrade. We embolized the recanalized pseudoaneurysm using metallic coils for isolation. Our experience indicates that adequate concentration and volume of the NBCA-lipiodol mixture should be considered depending on the vascular spasm in a patient with hypovolemic shock.
authors.affiliation: Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, Japan. masaishi@hiroshima-u.ac.jp
authors.forename: Masaki
authors.initials: M
authors.lastname: Ishikawa
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kakizawa
authors.forename: Wataru
authors.initials: W
authors.lastname: Yamasaki
authors.forename: Syuji
authors.initials: S
authors.lastname: Date
authors.forename: Masashi
authors.initials: M
authors.lastname: Hieda
authors.forename: Kenji
authors.initials: K
authors.lastname: Kajiwara
authors.forename: Kazuo
authors.initials: K
authors.lastname: Awai
mesh_terms: D000368:Aged; D002408:Catheters, Indwelling; D003487:Cyanoacrylates / Q000627:therapeutic use*; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D008297:Male; D013157:Splenic Artery / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D014947:Wounds and Injuries / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*
chemical_list: D003487:Cyanoacrylates