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A New Flow Control Technique Using Diluted Epinephrine in the N-butyl-2-cyanoacrylate Embolization of Visceral Artery Pseudoaneurysms Secondary to Chronic Pancreatitis

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Abstract

Although n-butyl-2-cyanoacrylate (NBCA) has been used as an effective liquid embolization material, its indication for pseudoaneurysms has seemingly been limited because of the technical difficulties of using NBCA, such as reflux to the parent artery and causing significant infarction. Thus, considerable skill in using NBCA or a device to control blood flow during its polymerization is required to achieve embolization without severe complications. We report our new technique for controlling blood flow using diluted epinephrine in transcatheter arterial NBCA embolization of five pseudoaneurysms in four cases secondary to hemosuccus pancreaticus.

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References

  1. Miki S, Mori K, Masanari S et al (2009) Hemosuccus pancreaticus in a patient with iodine allergy: successful diagnosis with magnetic resonance imaging and treatment with transarterial embolization using carbon dioxide as the contrast medium. Cardiovasc Intervent Radiol 32(6):1296–1299

    Article  PubMed  Google Scholar 

  2. Koren M, Kinova S, Bedeova J et al (2008) Hemosuccus pancreaticus. Bratisl Lek Listy 109(1):37–41

    PubMed  CAS  Google Scholar 

  3. Benz CA, Jakob P, Jakobs R et al (2000) Hemosuccus pancreaticus: a rare cause of gastrointestinal bleeding, diagnosis and interventional radiological therapy. Endoscopy 32:428–431

    Article  PubMed  CAS  Google Scholar 

  4. Kirby JM, Vora P, Midia M et al (2008) Vascular complications of pancreatitis: imaging and intervention. Cardiovasc Interv Radiol 31(5):957–970

    Article  Google Scholar 

  5. Udd M, Leppäniemi AK, Bidel S et al (2007) Treatment of bleeding pseudoaneurysms in patients with chronic pancreatitis. World J Surg 31(3):504–510

    Article  PubMed  Google Scholar 

  6. Bergert H, Dobrowolski F, Caffier S et al (2004) Prevalence and treatment of bleeding complications in chronic pancreatitis. Langenbeck Arch Surg 389(6):504–510

    Article  CAS  Google Scholar 

  7. Iwama Y, Sugimoto K, Zamora CA et al (2006) Transcatheter embolization of splenic artery pseudo-aneurysm rupturing into colon after post-operative pancreatitis. Cardiovasc Intervent Radiol 29(1):133–136

    Article  PubMed  Google Scholar 

  8. Garg A, Banait S, Babhad S et al (2007) Endovascular treatment of pseudoaneurysm of the common hepatic artery with intra-aneurysmal glue (N-butyl 2-cyanoacrylate) embolization. Cardiovasc Intervent Radiol 30(5):999–1002

    Article  PubMed  Google Scholar 

  9. Loffroy R, Guiu B, Cercueil JP et al (2008) Transcatheter arterial embolization of splenic artery aneurysms and pseudoaneurysms: short- and long-term results. Ann Vasc Surg 22(5):618–626

    Article  PubMed  Google Scholar 

  10. Boijsen E, Redman H (1967) Effect of epinephrine on celiac and superior mesenteric angiography. Invest Radiol 2(3):184–199

    Article  PubMed  CAS  Google Scholar 

  11. Stabile BE, Wilson SE, Debas HT (1983) Reduced mortality from bleeding pseudocysts and pseudoaneurysms caused by pancreatitis. Arch Surg 118(1):45–51

    Article  PubMed  CAS  Google Scholar 

  12. Izaki K, Yamaguchi M, Kawasaki R et al (2011) N-butyl cyanoacrylate embolization for pseudoaneurysms complicating pancreatitis or pancreatectomy. J Vasc Interv Radiol 22(3):302–308

    Article  PubMed  Google Scholar 

  13. Tokuda T, Tanigawa N, Shomura Y et al (2009) Transcatheter embolization for peripheral pseudoaneurysms with n-butyl cyanoacrylate. Minim Invasive Ther Allied Technol 18(6):361–365

    Article  PubMed  Google Scholar 

  14. Montgomery ML, Harisinghani MG, Norbash AM et al (2005) CT and fluoroscopically guided percutaneous embolization treatment of a pseudoaneurysm associated with pancreatitis. J Vasc Interv Radiol 16(3):411–415

    Article  PubMed  Google Scholar 

  15. Basile A, Lupattelli T, Magnano M et al (2007) Treatment of a celiac trunk aneurysm close to the hepato-splenic bifurcation by using hepatic stent-graft implantation and splenic artery embolization. Cardiovasc Interv Radiol 30(1):126–128

    Article  Google Scholar 

  16. Dasgupta R, Davies NJ, Williamson RC, Jackson JE (2002) Haemosuccus pancreaticus: treatment by arterial embolization. Clin Radiol 57(11):1021–1027

    Article  PubMed  CAS  Google Scholar 

  17. Loffroy R, Rao P, Ota S et al (2010) Packing technique for endovascular coil embolisation of peripheral arterial pseudo-aneurysms with preservation of the parent artery: safety, efficacy and outcomes. Eur J Vasc Endovasc Surg 40(2):209–215

    Article  PubMed  CAS  Google Scholar 

  18. Vujic I, Anderson BL, Stanley JH et al (1984) Pancreatic and peripancreatic vessels: embolization for control of bleeding in pancreatitis. Radiology 150:51–55

    PubMed  CAS  Google Scholar 

  19. Venkatesh SK, Kumar S, Baijal SS et al (2005) Endovascular management of pseudoaneurysms of the splenic artery: experience with six patients. Australas Radiol 49(4):283–288

    Article  PubMed  CAS  Google Scholar 

  20. Tulsyan N, Kashyap VS, Greenberg RK et al (2007) The endovascular management of visceral artery aneurysms and pseudoaneurysms. J Vasc Surg 45(2):276–283

    Article  PubMed  Google Scholar 

  21. Song HH, Won YD, Kim YJ (2010) Transcatheter N-butyl cyanoacrylate embolization of pseudoaneurysms. J Vasc Interv Radiol 21(10):1508–1511

    Article  PubMed  Google Scholar 

  22. Will U, Mueller AK, Grote R, Meyer F (2008) “Hemosuccus pancreaticus”: primarily ultrasound-guided successful intervention using transcutaneous fibrin glue application and histoacryl injection. Ultraschall Med 29(Suppl 5):260–263

    Article  PubMed  Google Scholar 

  23. Yamagami T, Kato T, Iida S et al (2004) Value of transcatheter arterial embolization with coils and n-butyl cyanoacrylate for long-term hepatic arterial infusion chemotherapy. Radiology 230:792–802

    Article  PubMed  Google Scholar 

  24. Suh DC, Kim KS, Lim SM et al (2003) Technical feasibility of embolizing aneurysms with glue (N-butyl 2-cyanoacrylate): experimental study in rabbits. Am J Neuroradiol 24:1532–1539

    PubMed  Google Scholar 

  25. Katsumori T, Higaki T, Shigematsu T et al (1995) A case of splenic pseudoaneurysm caused by balloon catheter: a complication of IVR for continuous arterial infusion therapy against severe acute pancreatitis. Jpn J Intervent Radiol 10(2):197–200

    Google Scholar 

  26. Steckel RJ, Tobin PL, Stein JJ et al (1969) Intra-arterial epinephrine protection against radiation nephritis. A progress report. Radiology 92:1341–1345

    PubMed  CAS  Google Scholar 

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Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Japan Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, 605-0981, Japan

    Hiroyuki Morishita, Tomohiro Matsumoto, Shunsuke Asai, Koji Masui & Osamu Sato

  2. Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyou, Kyoto, 602-8566, Japan

    Takuji Yamagami & Tsunehiko Nishimura

  3. Division of Diagnostic Radiology, National Cancer Center, Tsukiji Campus Hospital, 5-1-1 Tsukiji, Chuo, Tokyo, 104-0045, Japan

    Yoshito Takeuchi

  4. Department of Gastroenterology, Japan Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, 605-0981, Japan

    Hideki Sato

  5. Department of Surgery, Japan Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, 605-0981, Japan

    Fumihiro Taniguchi

Authors
  1. Hiroyuki Morishita
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  2. Takuji Yamagami
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  3. Yoshito Takeuchi
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  4. Tomohiro Matsumoto
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  5. Shunsuke Asai
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  6. Koji Masui
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  7. Hideki Sato
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  8. Fumihiro Taniguchi
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  9. Osamu Sato
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  10. Tsunehiko Nishimura
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Correspondence to Hiroyuki Morishita.

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Morishita, H., Yamagami, T., Takeuchi, Y. et al. A New Flow Control Technique Using Diluted Epinephrine in the N-butyl-2-cyanoacrylate Embolization of Visceral Artery Pseudoaneurysms Secondary to Chronic Pancreatitis. Cardiovasc Intervent Radiol 35, 932–937 (2012). https://doi.org/10.1007/s00270-011-0294-8

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  • DOI: https://doi.org/10.1007/s00270-011-0294-8

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