3:54 PMAbstract No. 233 - Transcatheter embolization of hepatic artery injury: retrospective analysis of FuAiLe medical glue

Abstract

To assess procedural success and clinical outcomes of transcatheter embolization of hepatic artery injury with FuAiLe medical glue (FAL). This is a retrospective analysis of outcome, cost and time of FAL embolization in 33 patients treated between February 2012 and September 2014 for hepatic artery bleeding. Hepatic arterial embolization was considered based on the findings of initial CT scan, laboratory results, and clinical signs of acute bleeding. All blunt abdominal trauma patients were classified after CT scan according to the Trauma Classification (grades I-V) of the American Association for Surgery. Superselective hepatic arterial embolization was carried out all patients. A microcatheter was advanced to the target vessel through the existing 5-Fr Yashiro catheter. FAL was mixed with Lipiodol at a 1:1 ratio. The FAL was injected under fluoroscopic guidance. Postembolization hepatic arteriography was obtained to determine the embolic result. 33 patients (24 men, 9 women) with mean age 37.9 years (range, 12-62) underwent hepatic artery embolization. The emergent hepatic artery injuries secondary to: traffic accident (n=21), high fall (n=8), post percutaneous liver biopsy (n=2) and transhepatic cholangial drainage (n=2). FAL mixture injection (mean volume: 0.9 mL; range, 0.5–1.8 mL) effectively controlled hepatic artery bleeding without embolic agent reflux or hematoma progression. There was no patient need for further endovascular or surgical intervention. The average cost of FAL for each procedure was $80 USD. Within 2 weeks post embolization, 4 (12.1%) patients developed hepatic abscesses distal to the embolization sites (Trauma Classification, 2 were grade IV and 2 were grade III), which were diagnosed by CT scan and successfully treated by percutaneous drainage and antibiotic treatment. During follow-up, no definite recurrent hemorrhage was identified from hepatic vascular lesions in which initial hemostasis was achieved. In the treatment of active hepatic artery bleeding by superselective embolization with FAL medical glue is a reasonable and an effective therapeutic technique.