Bilen ONAN, Hüseyin AKKAYA, Sinan SÖZÜTOK, Ferhat Can PİŞKİN, Ömer KAYA, Tuğsan BALLI

Akut Arteriyel Kanamalarda Transkatater Siyanoakrilat Glue Embolizasyonun Güvenliğinin ve Etkinliğinin Değerlendirilmesi

Amaç: Akut kanamalarda N-butyl cyanoacrylate glue ile yapılan endovasküler embolizasyonun güvenliğini ve etkinliğini göstermek. Gereç ve Yöntem: Akut visseral kanama nedeni ile tarafımızca glue ile endovasküler embolizasyon uygulanan toplam 31 hastanın verileri retrospektif olarak değerlendirildi. Hastalara işlem öncesi kanama odağını saptama amacıyla rutin olarak kontrastsız ve kontrastlı fazlardan oluşan şüphe edilen kanama bölgesine yönelik bilgisayarlı tomografi çekildi. Teknik başarı kontrol anjiografide hedeflenen damarın kapatılması, klinik başarı ise post-op 1 aylık sürede tekrar işlem gerektirecek kanama olmaması şeklinde kabul edildi. Bulgular: Maligniteye bağlı gastrointestinal sistem (GİS), vajinal kanama ya da hematürisi olan 11 hasta, enfeksiyon sekeli ya da bronşektaziye bağlı hemoptizisi olan 9 hasta, perkütan tıbbi işlemler sonrası kanaması olan 4 hasta, travmaya bağlı kanaması olan 3 hasta, peptik ülser nedeni ile kanaması olan 4 hasta endovasküler embolizasyon ile tedavi edildi. 17 hastada %5’lik, 14 hastada ise %10’luk glue-lipiodol karışımı embolizasyon için kullanıldı. Sonuç: N-butil siyanoakrilat aktif kanaması olan hastalarda teknik ve klinik başarısı yüksek güvenilir bir embolizan materyaldir.

Anahtar Kelimeler:

N-butil siyanoakrilat glue, embolizasyon, hemoraji, endovasküler tedavi

Evaluation of the Safety and Efficacy of Transcatheter Cyanoacrylate Glue Embolization in Acute Arterial Bleeding

Objective: To demonstrate the safety and efficacy of endovascular embolization with N-butyl cyanoacrylate glue in acute bleeding. Methods: The data of 31 patients who underwent endovascular embolization using glue due to acute visceral hemorrhage were retrospectively evaluated. In order to detect the bleeding focus before the procedure, computed tomography with contrast-enhanced and non-contrast phases was routinely performed on the suspected bleeding site. Technical success was accepted as the closure of the targeted artery in control angiography, and clinical success was defined as the absence of bleeding that would require reoperation within one month postoperatively. Results: Eleven patients with gastrointestinal tract or vaginal bleeding or hematuria due to malignancy, nine with hemoptysis due to infection sequelae or bronchiectasis, four with bleeding secondary to percutaneous medical procedures, three with trauma-related hemorrhage, and four with hemorrhage due to peptic ulcers were treated with endovascular embolization. Embolization was undertaken using a glue-lipiodol mixture of 5% in 17 patients and 10% in 14 patients. Conclusion: N-butyl cyanoacrylate is a safe embolizing material with high technical and clinical success in patients with active bleeding.

Keywords:

N-butyl cyanoacrylate glue, embolization, hemorrhage, endovascular treatment,

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