Intra-arterial tissue adhesive for medical splenectomy in humans

Bucrylate (isobutyl 2-cyanoacrylate) was used for the transcatheter embolization of the splenic artery in 4 patients with bleeding gastric varices secondary to splenic vein thrombosis, 3 patients with symptoms of hypersplenism, and 8 patients with bleeding esophageal varices secondary to portal hypertension. The splenic artery was completely occluded in 13 patients and partially occluded in 2. In all but one of the patients, functioning splenic tissue was preserved and no abscess developed. Medical splenectomy with Bucrylate appears to be a safe and effective method for treating bleeding gastric varices secondary to splenic vein thrombosis, and it can alleviate symptoms of hypersplenism. Its role in controlling bleeding from esophageal varices in patients with generalized portal hypertension is worth further study.