Safety and Efficacy of Coil Embolization in Treating Vascular Complications of Pancreatitis

Abstract

Introduction: Acute pancreatitis is an acute inflammatory process of the pancreas. Most patients recover without any major sequelae; however a minority of patients have life threatening vascular complications. Vascular complications of pancreatitis include arterial erosion, pseudo aneurysm, ischemic complications, remote vascular complications, venous thrombosis and varices. We studied patients to study safety and efficacy of coil embolization in treating vascular complications pancreatitis and to reduce morbidity and mortality rates. Methods: This prospective study was conducted from July 2014 to February 2016 at Department of Radiology, Government Medical College Nagpur, in which all patients who presented with vascular complications of pancreatitis were enrolled to undergo embolization using coiling, N-butyl cyanoacrylateglue or gluefoam. The patients were followed to see rebleeding and treatment failure rates. Results: 38 patients were included in the study, of which 33 had pseudoaneurysm and 5 had arterial wall erosions. The most common artery involved was splenic artery in both acute and chronic pancreatitis patients. For treatment, only embolization coils were used in 76% of the patients. There were no occurrences of bowel ischemia, hepatic insufficiency, or rupture-related deaths in any of patients in the follow-up period. Conclusions: Results of embolization of pseudoaneurysms with coils showed high success rate and good short & long term outcome. More research is required to search for better embolization materials which can minimize the risk of rebleeds or other complications.