International Journal of Gastrointestinal Intervention

pISSN 2636-0004 eISSN 2636-0012

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< Previous Next >Gastrointestinal Intervention 2018; 7(3): 99~175

Review Article 2018-10-31

Is glue embolization safe and effective for gastrointestinal bleeding?

Shinsaku Yata , Yasufumi Ohuchi, Akira Adachi, Masayuki Endo, Shohei Takasugi, Kazumichi Tsukamoto, Kensuke Matsumoto, Mika Kodani, Jun Makishima, and Shinya Fujii

https://doi.org/10.18528/gii180030

Abstract : Transcatheter arterial embolization using N-butyl-2-cyanoacrylate (NBCA) for gastrointestinal arterial bleeding enables higher cessation rate and lower recurrent bleeding rate compared with conventional embolic materials including gelatin sponge, metallic coil, and polyvinyl alcohol (PVA) particle. Glue embolization is particularly effective in patients with coagulopathy. Even in the lower gastrointestinal tract, ischemic bowel complications by glue embolization are comparable to other agents. Glue embolization is also effective for arterial esophageal bleeding without any serious ischemic complications although the anatomy of the esophageal artery is complex and varied. For bleeding after abdominal surgery such as pancreaticoduodenectomy or hepatic lobectomy, interventional radiologists should be careful with indicating glue embolization because the presence of fewer collateral vessels can easily result in serious ischemic complications. Modified glue such as Glubran 2 (NBCA associated with methacryloxysulfolane) can reduce the risk of ischemic complication due to its less thermal reaction, but the outcomes seem unsatisfactory.

Cited By: 2

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Review Article 2018-10-31

Endovascular treatment of pancreatitis-related gastrointestinal bleeding

Seung Yeon Noh, and Ji Hoon Shin

https://doi.org/10.18528/gii180032

Abstract : Hemorrhage following pancreatitis may become complicated during the disease course and with possibly fatal consequences. Radiologic findings are as follows: the presence of hematomas, hemorrhagic pseudocysts, extravasation of contrast media or the formation of arterial pseudoaneurysms. The digital subtraction angiography findings are as follows: contrast extravasation due to arterial rupture; pseudoaneurysm formation; and luminal irregularity. A pseudoaneurysm is considered to be treated as soon as detected due to its risk of rupture. Endovascular management, which includes embolization using coils, N-butyl cyanoacrylate, gelatin sponge, stents, and thrombin, is an effective option for the treatment for pancreatitis-related bleeding.

Cited By: 0

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Original Article 2018-10-31

Transjugular intrahepatic portosystemic shunt creation for portal hypertension in patients with hepatocellular carcinoma: A systematic review

He Zhao, Jiaywei Tsauo , Xiaowu Zhang, Tao Gong, Jinggui Li, and Xiao Li

https://doi.org/10.18528/gii180026

Abstract : Background To evaluate the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) creation for the management of portal hypertension in patients with hepatocellular carcinoma (HCC). Methods A literature search of the MEDLINE/PubMed and Embase databases was conducted. All articles reporting the outcomes of TIPS creation for variceal bleeding and refractory ascites and hepatic hydrothorax in patients with HCC were included. Exclusion criteria were non-English language, sample size < 5, data not extractable, and data reported in another article. Results A total of 280 patients (mean age, 48–58; male gender, 66%) from five articles were included. TIPS creation was performed for variceal bleeding in 79% and refractory ascites and/or hepatic hydrothorax in 26% of patients. Technical and clinical success was achieved in 99% and 64% of patients, respectively. Clinical failure occurred in 36% of patients due to rebleeding or recurrent bleeding (n = 77) or no resolution or improvement of refractory ascites and hepatic hydrothorax (n = 24). One percent of patient had major complications, including accelerated liver failure (n = 1) and multi-organ failure resulting from hemorrhagic shock (n = 1), all of which resulted in early (i.e., within 30 days) death. Hepatic encephalopathy occurred in 40% of patients after TIPS creation. Lung metastasis was found 1% of patient 5 months (n = 1) and 72 months (n = 1) after TIPS creation. Conclusion TIPS creation seems to be safe and effective for the management of portal hypertension in patients with HCC.

Cited By: 6

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Case Report 2018-10-31

Balloon dilation of epidermolysis bullosa-related esophageal strictures: A report of two cases

Wei-Zhong Zhou, Jing-Guo Xia, Zheng-Qiang Yang , Chun-Gao Zhou, Lin-Bo Zhao, Sheng Liu, and Hai-Bin Shi

https://doi.org/10.18528/gii170030

Abstract : Epidermolysis bullosa (EB) is a very rare inherited disease featured with skin blistering resulting from minor trauma. Sometimes the esophageal mucosa could also be involved, which leads to esophageal strictures. Here we report two cases of EB-related esophageal strictures who were successfully treated with esophageal balloon dilations. The two cases with EB had severe dysphagia. Clinical examination showed signs of malnutrition, skin blisters and loss of toenails due to EB. They underwent careful fluoroscopic balloon dilation with 10- and 16-mm-sized balloon catheters, respectively. They could ingest soft and some solid foods after the procedure and maintained during the 20 months and 16 months follow-up periods.

Cited By: 0

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