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Safety and efficacy of transcatheter embolization with Glubran®2 cyanoacrylate glue for acute arterial bleeding: a single-center experience with 104 patients

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Abstract

Purpose

To assess the efficacy and the safety of Glubran®2 n-butyl cyanoacrylate metacryloxysulfolane (NBCA-MS) transcatheter arterial embolization (TAE) for acute arterial bleeding from varied anatomic sites and to evaluate the predictive factors associated with clinical success and 30-day mortality.

Methods

A retrospective review of consecutive patients who underwent emergent NBCA-MS Glubran®2 TAE between July 2014 and August 2016 was conducted. Variables including age, sex, underlying malignancy, cardiovascular comorbidities, coagulation data, systolic blood pressure, and number of red blood cells units (RBC) transfused before TAE were collected. Clinical success, 30-day mortality, and complication rates were evaluated. Prognostic factors were evaluated by uni- and multivariate logistic regression analyses for clinical success, and by uni- and bivariate analyses after adjustment by bleeding sites for 30-day mortality.

Results

104 patients underwent technically successful embolization with bleeding located in muscles (n = 34, 32.7%), digestive tract (n = 28, 26.9%), and viscera (n = 42, 40.4%). Clinical success rate was 76% (n = 79) and 30-day mortality rate was 21.2% (n = 22). Clinical failure was significantly associated with mortality (p < 0.0001). A number of RBC units transfused greater than or equal to 3 were associated with poorer clinical success (p = 0.025) and higher mortality (p = 0.03). Complications (n = 4, 3.8%) requiring surgery occurred only at puncture site. No ischemic complications requiring further invasive treatment occurred. Mean TAE treatment time was 4.55 min.

Conclusions

NBCA-MS Glubran®2 TAE is a fast, effective, and safe treatment for acute arterial bleeding whatever the bleeding site.

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Author information

Authors and Affiliations

  1. Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Bourgogne-Franche-Comté, 14 Rue Gaffarel, BP 77908, 21079, Dijon Cedex, France

    Gilles Abdulmalak, Olivier Chevallier, Nicolas Falvo, Lucy Di Marco, Benjamin Moulin, Célina Abi-Khalil, Sophie Gehin, Marco Midulla & Romaric Loffroy

  2. Department of Epidemiology and Biostatistics, Georges François Leclerc Center, Dijon, France

    Aurélie Bertaut

  3. Department of Medical Intensive Care, François-Mitterrand Teaching Hospital, University of Bourgogne-Franche-Comté, Dijon, France

    Pierre-Emmanuel Charles

  4. Department of Gastroenterology and Hepatology, François-Mitterrand Teaching Hospital, University of Bourgogne-Franche-Comté, Dijon, France

    Marianne Latournerie

Authors
  1. Gilles Abdulmalak
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  2. Olivier Chevallier
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  3. Nicolas Falvo
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  4. Lucy Di Marco
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Correspondence to Romaric Loffroy.

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Abdulmalak, G., Chevallier, O., Falvo, N. et al. Safety and efficacy of transcatheter embolization with Glubran®2 cyanoacrylate glue for acute arterial bleeding: a single-center experience with 104 patients. Abdom Radiol 43, 723–733 (2018). https://doi.org/10.1007/s00261-017-1267-4

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  • DOI: https://doi.org/10.1007/s00261-017-1267-4

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