ITALIAN SOCIETY FOR THE STUDY OF VASCULAR ANOMALIES (SISAV)
CONGRESS 2014 

International Angiology 2015 December;34(6 Suppl 1):28-35

Copyright © 2015 EDIZIONI MINERVA MEDICA

lingua: Inglese

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

Ierardi A. M. ¹, Xhepa G. ¹, Duka E. ¹, Laganà D. ¹, Ianniello A. ², Floridi C. ¹, Bacuzzi A. ¹, Reginelli A. ⁴, Squillaci E. ⁵, Brunese L. ⁶, Carrafiello G. ¹ ✉

¹ Unit of Interventional Radiology, Department of Radiology, Insubria University, Varese, Italy; ² Department of Radiology, G. Salvini Hospital, Garbagnate Milanese, Milan, Italy; ³ Anesthesia and Palliative Care, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy; ⁴ Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology, Second University of Naples, Naples, Italy; ⁵ Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, University of Rome Tor Vergata, Rome, Italy; ⁶ Department of Medicine and Health Science, University of Molise, Campobasso, Italy

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.