Selective Arterial Embolization-Reply

Abstract

In response to the points raised by Drs Clare and Ghidoni, we agree that selective arterial embolization carries the risk of occlusion of arteries other than those intended. The angiographic techniques employed require precision and judgment, and even in extreme situations they cannot be regarded casually. The use of balloon-tipped catheters to prevent the reflux of emboli may be helpful in safeguarding critical areas such as the cerebral circulation. We have used embolization with absorbable gelatin sponge in more than 100 cases, and, although we have occasionally seen absorbable gelatin sponge particles dislodge from their intended position, we fortunately have not seen a case where aberrant emboli resulted in death or serious complication. Some causes of upper gastrointestinal hemorrhage are more effectively treated with vasopressin infusion than with embolization, and we rely heavily on endoscopy prior to the angiogram to formulate the right approach. Unless endoscopy is unsuccessful