Gelfoam and autologous clot embolization: effect on coagulation

Area of Science:

• Gastroenterology
• Interventional Radiology
• Hematology

Background:

• Esophageal varices in liver disease patients pose a bleeding risk.
• Therapeutic embolization using gelfoam and autologous clot is a method to control such bleeding.
• Disseminated intravascular coagulation is a potential complication.

Observation:

• A case of disseminated intravascular coagulation (DIC) after gelfoam embolization for esophageal varices was observed.
• A prospective study followed 13 patients (6 control, 7 gelfoam/autologous clot) to assess clotting effects.
• Standard coagulation parameters (PT, aPTT, TT, fibrinogen, platelets) were measured.

Findings:

• No significant differences in standard coagulation tests were found between control and gelfoam/autologous clot groups.
• Fibrin (ogen) degradation products were significantly elevated in the gelfoam/autologous clot group (p < .01).
• This elevation is suspected to be secondary to clot lysis at the embolization site.

Implications:

• Gelfoam embolization may lead to clot lysis and elevated fibrin degradation products.
• Despite elevated fibrin degradation products, no subsequent bleeding diathesis was observed in the studied patients.
• This suggests that elevated fibrin degradation products post-embolization may not necessarily indicate a clinically significant bleeding risk.