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Transcatheter arterial embolization of cystic artery bleeding
Hyo-Cheol Kim1, Yun Soo Jeong1, Kichang Han2
1Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Insights
Transcatheter arterial embolization (TAE) via the cystic artery shows high technical success for bleeding control. However, clinical success is limited by patient comorbidities and post-procedure ischemic cholecystitis.
Area of Science:
- Interventional Radiology
- Vascular Surgery
- Gastroenterology
Background:
- Cystic artery bleeding is a serious condition requiring effective treatment.
- Transcatheter arterial embolization (TAE) is a minimally invasive option for managing arterial hemorrhage.
Purpose of the Study:
- To evaluate the safety and clinical outcomes of TAE specifically targeting the cystic artery for bleeding.
- To identify factors contributing to technical and clinical success or failure.
Main Methods:
- Retrospective review of 20 patients who underwent TAE via the cystic artery (January 2010 - May 2022).
- Assessment of radiological images and clinical data to determine bleeding causes, complications, and outcomes.
- Technical success defined by angiography; clinical success by absence of bleeding complications at discharge.
Main Results:
- Hemorrhagic cholecystitis was the most frequent cause of bleeding (n=10).
- All cases achieved technical success (100%).
- Clinical success was observed in 70% of patients (n=14), with 3 developing ischemic cholecystitis and 6 experiencing mortality within 45 days.
Conclusions:
- TAE via the cystic artery offers a high rate of technical success in controlling cystic artery bleeding.
- Clinical outcomes are frequently impacted by pre-existing medical conditions and the development of ischemic cholecystitis, leading to significant failure rates.
Purpose:
The purpose of this study is to assess the safety and clinical outcomes of transcatheter arterial embolization (TAE) via the cystic artery for treating patients with bleeding from the cystic artery.
Materials And Methods:
This retrospective study included 20 patients who underwent TAE via the cystic artery between January 2010 and May 2022. Radiological images and clinical data were reviewed to evaluate causes of bleeding, procedure-related complications, and clinical outcomes. Technical success was defined as the disappearance of contrast media extravasation or pseudoaneurysm, as demonstrated on completion angiography. Clinical success was defined as discharge from the hospital without any bleeding-related issues.
Results:
Hemorrhagic cholecystitis (n = 10) was the most common cause of bleeding, followed by iatrogenic (n = 4), duodenal ulcer (n = 3), tumor (n = 2), and trauma (n = 1). Technical success was achieved in all cases, and clinical success was achieved in 70% (n = 14) of patients. Three patients developed ischemic cholecystitis as a complication. Six patients with clinical failure died within 45 days after embolization.
Conclusion:
TAE through the cystic artery has a high technical success rate in treating cystic artery bleeding, but clinical failure remains a common occurrence due to concurrent medical conditions and the development of ischemic cholecystitis.
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