Transarterial embolization of acute non-neurologic bleeding using Ethylene Vynil Alcohol Copolymer: a single-Centre retrospective study
Abstract Background To evaluate feasibility, safety and effectiveness of transarterial embolization of acute non-neurologic hemorrhage with Ethylene Vynil Alcohol Copolymer (EVOH). Methods Between January 2018 and June 2021, 211 patients (male 123, mean age 69.7 y + 17.9) who underwent transarterial...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-01-01
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| Series: | CVIR Endovascular |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42155-023-00347-0 |
| _version_ | 1811175686879051776 |
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| author | Paolo Rabuffi Antonio Bruni Enzo Maria Gabriele Antonuccio Andrea Saraceni Simone Vagnarelli |
| author_facet | Paolo Rabuffi Antonio Bruni Enzo Maria Gabriele Antonuccio Andrea Saraceni Simone Vagnarelli |
| author_sort | Paolo Rabuffi |
| collection | DOAJ |
| description | Abstract Background To evaluate feasibility, safety and effectiveness of transarterial embolization of acute non-neurologic hemorrhage with Ethylene Vynil Alcohol Copolymer (EVOH). Methods Between January 2018 and June 2021, 211 patients (male 123, mean age 69.7 y + 17.9) who underwent transarterial embolization with Onyx™ for acute non-neurologic arterial bleeding were retrospectively reviewed. Most frequent etiology of bleeding was post-operative (89/211, 42.2%), trauma (62/211, 29.4%) and tumor (18/211, 8.5%). Technical success was defined as the angiographic evidence of target vessel complete occlusion. Clinical success was defined as resolution of bleeding. Any rebleeding within the primitive site, requiring a new intervention during the first 30-days following embolization, was considered a clinical failure. Occurrence of procedure-related complication and mortality within 30 days of the embolization were examined. Results A total of 229 embolization procedures was performed in 211 pts.; technical success rate was 99.5% (210/211 pts). Clinical success rate was 94.3% (199/211 pts). In 11 patients (5.2%) a reintervention was needed because of a rebleeding occurring within the primitive site, whereas in five patients (2.4%) rebleeding occurred within a site different from the primitive. Factors more often associated with clinical failure were coagulopathy/ongoing anticoagulant therapy (5/11, 45.4%), and post-operative etiology (3/11, 27.3%). EVOH was used as the sole embolic agent in 214/229 procedures (93.4%), in association with coils in 11 cases (4.8%), and with microparticles in 4 cases (1.7%). In the present series, major complications occurred in 6 cases (2.8%): respectively, four cases (1.9%) of colonic ischemia and two groin hematomas (0.9%) with active extravasation were observed. 26 (12.3%) patients died during the follow-up. Conclusion Embolization of acute arterial bleeding with EVOH as a first-line embolic agent is feasible, safe and effective. |
| first_indexed | 2024-04-10T19:39:49Z |
| format | Article |
| id | doaj.art-5c3ed5b81582418793bcebd645c168d2 |
| institution | Directory Open Access Journal |
| issn | 2520-8934 |
| language | English |
| last_indexed | 2024-04-10T19:39:49Z |
| publishDate | 2023-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | CVIR Endovascular |
| spelling | doaj.art-5c3ed5b81582418793bcebd645c168d22023-01-29T12:22:43ZengSpringerOpenCVIR Endovascular2520-89342023-01-01611810.1186/s42155-023-00347-0Transarterial embolization of acute non-neurologic bleeding using Ethylene Vynil Alcohol Copolymer: a single-Centre retrospective studyPaolo Rabuffi0Antonio Bruni1Enzo Maria Gabriele Antonuccio2Andrea Saraceni3Simone Vagnarelli4Unit of Interventional Radiology, Azienda Ospedaliera San Giovanni AddolorataUnit of Interventional Radiology, Azienda Ospedaliera San Giovanni AddolorataUnit of Interventional Radiology, Azienda Ospedaliera San Giovanni AddolorataUnit of Interventional Radiology, Azienda Ospedaliera San Giovanni AddolorataUnit of Interventional Radiology, Azienda Ospedaliera San Giovanni AddolorataAbstract Background To evaluate feasibility, safety and effectiveness of transarterial embolization of acute non-neurologic hemorrhage with Ethylene Vynil Alcohol Copolymer (EVOH). Methods Between January 2018 and June 2021, 211 patients (male 123, mean age 69.7 y + 17.9) who underwent transarterial embolization with Onyx™ for acute non-neurologic arterial bleeding were retrospectively reviewed. Most frequent etiology of bleeding was post-operative (89/211, 42.2%), trauma (62/211, 29.4%) and tumor (18/211, 8.5%). Technical success was defined as the angiographic evidence of target vessel complete occlusion. Clinical success was defined as resolution of bleeding. Any rebleeding within the primitive site, requiring a new intervention during the first 30-days following embolization, was considered a clinical failure. Occurrence of procedure-related complication and mortality within 30 days of the embolization were examined. Results A total of 229 embolization procedures was performed in 211 pts.; technical success rate was 99.5% (210/211 pts). Clinical success rate was 94.3% (199/211 pts). In 11 patients (5.2%) a reintervention was needed because of a rebleeding occurring within the primitive site, whereas in five patients (2.4%) rebleeding occurred within a site different from the primitive. Factors more often associated with clinical failure were coagulopathy/ongoing anticoagulant therapy (5/11, 45.4%), and post-operative etiology (3/11, 27.3%). EVOH was used as the sole embolic agent in 214/229 procedures (93.4%), in association with coils in 11 cases (4.8%), and with microparticles in 4 cases (1.7%). In the present series, major complications occurred in 6 cases (2.8%): respectively, four cases (1.9%) of colonic ischemia and two groin hematomas (0.9%) with active extravasation were observed. 26 (12.3%) patients died during the follow-up. Conclusion Embolization of acute arterial bleeding with EVOH as a first-line embolic agent is feasible, safe and effective.https://doi.org/10.1186/s42155-023-00347-0Acute arterial hemorrhageEmbolizationEthylene vinyl alcohol copolymerOnyxEVOH |
| spellingShingle | Paolo Rabuffi Antonio Bruni Enzo Maria Gabriele Antonuccio Andrea Saraceni Simone Vagnarelli Transarterial embolization of acute non-neurologic bleeding using Ethylene Vynil Alcohol Copolymer: a single-Centre retrospective study CVIR Endovascular Acute arterial hemorrhage Embolization Ethylene vinyl alcohol copolymer Onyx EVOH |
| title | Transarterial embolization of acute non-neurologic bleeding using Ethylene Vynil Alcohol Copolymer: a single-Centre retrospective study |
| title_full | Transarterial embolization of acute non-neurologic bleeding using Ethylene Vynil Alcohol Copolymer: a single-Centre retrospective study |
| title_fullStr | Transarterial embolization of acute non-neurologic bleeding using Ethylene Vynil Alcohol Copolymer: a single-Centre retrospective study |
| title_full_unstemmed | Transarterial embolization of acute non-neurologic bleeding using Ethylene Vynil Alcohol Copolymer: a single-Centre retrospective study |
| title_short | Transarterial embolization of acute non-neurologic bleeding using Ethylene Vynil Alcohol Copolymer: a single-Centre retrospective study |
| title_sort | transarterial embolization of acute non neurologic bleeding using ethylene vynil alcohol copolymer a single centre retrospective study |
| topic | Acute arterial hemorrhage Embolization Ethylene vinyl alcohol copolymer Onyx EVOH |
| url | https://doi.org/10.1186/s42155-023-00347-0 |
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