Safety and efficacy of Glubran-2® endovascular embolization in acute bleeding patients with coagulopathies: a...

This study aims to analyze safety and effectiveness of glue (Glubran-2) embolization in acute bleeding patients with coagulopathies; data were analyzed according to two bleeding risk categories based on coagulation status.

This retrospective study included patients treated with glue endovascular embolization for acute bleedings in high-volume centers experienced with liquid embolics. Coagulopathy was defined as almost one of the following elements: international normalized ratio (INR) > 1.5; platelet count < 80.000/mm3; and anticoagulant and/or antiplatelet therapies at the time of embolization. If multiple conditions overlapped, patients were classified as high-risk category; otherwise, they were considered as standard risk.

Sixty-seven subjects were considered for this analysis. The underlying causes of bleeding were traumatic in 67.2% and spontaneous in 32.8%. At hospital admission, most patients were hemodynamically stable (86.6%). All patients took anticoagulant or antiplatelet therapies at the time of the intervention; 11.9% presented with INR > 1.5 and 14.9% had platelet counts < 80.000/mm3; 58.2% were classified as standard risk and 41.8% as high risk. Technical success was achieved in all cases while clinical success was obtained in 85%. In-hospital mortality was 6.0%. Procedure-related complications occurred in 4.5%. Comparing patients at high risk with those at standard risk, technical and clinical success rates were similar.

In this study Glubran-2 appeared to be an effective embolic glue in bleeding patients with coagulopathy, even in those subjects with multiple coagulopathic conditions increasing the risk of bleeding; future studies, including more patients and less trained operators, are required to confirm these outcomes.