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Superselective transcatheter arterial embolization in patients with acute peripancreatic bleeding complications: review of 44 cases

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Abstract

Purpose

To evaluate the efficacy of superselective transcatheter arterial embolization (TAE) in the treatment of acute peripancreatic bleeding complications.

Methods

During a 9-year period, 44 patients with acute bleeding of the peripancreatic arteries underwent TAE in our institution. Thirty-eight patients were treated using microcatheters and 6 patients with a diagnostic catheter. Embolic agents included coils (n = 38), polyvinyl alcohol (PVA) particles (n = 2), isobutyl cyanoacrylate (n = 2), coils plus PVA particles (n = 1), and coils plus isobutyl cyanoacrylate (n = 1). Outcome measures included technical success, clinical success, and the rate of complications.

Results

Identified bleeding sources included gastroduodenal artery (n = 14), splenic artery (n = 9), pancreaticoduodenal artery (n = 6), common hepatic artery (n = 5), superior mesenteric artery branches (n = 4), proper hepatic artery (n = 3), and dorsal/transverse pancreatic artery (n = 3). Technical success with effective control of active bleeding was achieved in 41/44 patients (93 %). Clinical success attributed to TAE alone was documented in 40/44 patients (91 %). The rate of major complications was 2 % including death in one patient.

Conclusions

Superselective TAE allows effective, minimally invasive control of acute peripancreatic bleeding complications with a low rate of therapeutically relevant complications.

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Acknowledgments

The linguistic help of Janet Jundler and Dr. Nina Rothschild, DrPH, MPH in the preparation of the manuscript is deeply appreciated.

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Authors and Affiliations

  1. Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, University of Bern, Bern, Switzerland

    Ralph Kickuth, Hanno Hoppe, Bettina Saar & Jürgen Triller

  2. Department of Radiology, University of Wuerzburg, Würzburg, Germany

    Ralph Kickuth

  3. Department of Radiology, Lindenhofspital, Bern, Switzerland

    Hanno Hoppe

  4. Department of Radiology, Hirslanden Klinik, Aarau, Switzerland

    Bettina Saar

  5. Department of Visceral Surgery and Medicine, Inselspital, University of Bern, Bern, Switzerland

    Daniel Inderbitzin & Jürgen Gschossmann

  6. Department of Surgery, soH Solothurner Spitäler, Solothurn, Switzerland

    Daniel Inderbitzin

  7. Department of Radiology, Spital Emmental, Burgdorf/Langnau, Switzerland

    Jürgen Triller

  8. Department of Statistics, University of Bamberg, Bamberg, Germany

    Susanne Raessler

  9. Department of Internal Medicine, Klinikum Forchheim, Forchheim, Germany

    Jürgen Gschossmann

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  1. Ralph Kickuth
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  2. Hanno Hoppe
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Correspondence to Jürgen Gschossmann.

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Our institution does not require Institutional Review Board approval for retrospective reports.

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Kickuth, R., Hoppe, H., Saar, B. et al. Superselective transcatheter arterial embolization in patients with acute peripancreatic bleeding complications: review of 44 cases. Abdom Radiol 41, 1782–1792 (2016). https://doi.org/10.1007/s00261-016-0772-1

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  • DOI: https://doi.org/10.1007/s00261-016-0772-1

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