Comparison of Hemostatic Durability between N-Butyl Cyanoacrylate and Gelatin Sponge Particles in Transcatheter Arterial Embolization for Acute Arterial Hemorrhage in a Coagulopathic Condition in a Swine Model

Journal Article · Wed Dec 15 00:00:00 EST 2010 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-010-9863-5· OSTI ID:21428887

Yonemitsu, Takafumi ^[1]; Kawai, Nobuyuki; Sato, Morio; Sonomura, Tetsuo; Takasaka, Isao; Nakai, Motoki; Minamiguchi, Hiroki; Sahara, Shinya ^[2]; Iwasaki, Yasuhiro; Naka, Toshio; Shinozaki, Masahiro ^[1]

---

1. Wakayama Medical University, Department of Critical Care Medicine (Japan)
2. Wakayama Medical University, Department of Radiology (Japan)

This study was designed to compare the efficacy of transcatheter arterial embolization (TAE) with N-butyl cyanoacrylate (NBCA) or gelatin sponge particles (GSP) for acute arterial bleeding in a coagulopathic condition using a swine model. Four healthy swine were divided into two coagulopathic conditions: mild and severe. Five hemorrhages were created in each swine (10 hemorrhages per coagulopathy). Mild coagulopathy was achieved by bloodletting 10% of the total circulatory whole blood and preserving activated clotting time (ACT) less than 200 s (ACT < 200 s state); severe coagulopathy was achieved by bloodletting 30% and preserving ACT > 400 s (ACT > 400-second state). For each state, of ACT < 200 s or ACT > 400 s, TAE was conducted with GSP or NBCA to control five hemorrhages arising from artificially created renal and splenic injuries. Angiography immediately after TAE with GSP or NBCA showed complete occlusion in both coagulopathic conditions. In the ACT < 200-second state, follow-up angiography at 5-30 min after TAE with GSP or NBCA showed no evidence of recurrent hemorrhage. In the ACT > 400-second state, follow-up angiography showed recurrent hemorrhage in four (80%) of the five hemorrhages embolized with GSP and in one (20%) of the five hemorrhages embolized with NBCA. Microscopically, red thrombi were observed densely surrounding GSP in mild coagulopathy but were scarce in severe coagulopathy. In a condition with severe coagulopathy, TAE with NBCA was more effective in durability to cease active arterial bleeding than with GSP.

• OSTI ID: 21428887
• Journal Information: Cardiovascular and Interventional Radiology, Vol. 33, Issue 6; Other Information: DOI: 10.1007/s00270-010-9863-5; Copyright (c) 2010 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); ISSN 0174-1551
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ACRYLATES
ARTERIES
BIOMEDICAL RADIOGRAPHY
COMPARATIVE EVALUATIONS
GELATIN
HEMORRHAGE
SWINE
TUBES
ANIMALS
BLOOD VESSELS
BODY
CARBOXYLIC ACID SALTS
CARDIOVASCULAR SYSTEM
COLLOIDS
DIAGNOSTIC TECHNIQUES
DISPERSIONS
DOMESTIC ANIMALS
EVALUATION
MAMMALS
MEDICINE
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANS
PATHOLOGICAL CHANGES
PROTEINS
RADIOLOGY
SYMPTOMS
VERTEBRATES