Abstract

BackgroundThe aim of this study is to evaluate the clinical efficacy and safety of transcatheter arterial embolization (TAE) with N-butyl cyanoacrylate (NBCA) for the treatment of arterial esophageal bleeding in esophageal cancer patients.MethodsBetween November 2008 and December 2014, five esophageal cancer patients underwent TAE with NBCA for the treatment of arterial esophageal bleeding. We retrospectively evaluated the technical and clinical success, recurrent bleeding, and procedure-related complications.ResultsAll of the patients had bleeding from the esophageal artery and were in shock at the beginning of TAE. Four patients had a coagulopathy at the time of TAE; however, the TAE could successfully arrest bleeding in all five patients. After TAE, they immediately recovered from the shock state. Two patients were discharged without event, one patient is currently hospitalized for another complication, and the other two patients died due to multiorgan failure. In addition, no procedure-related complications such as esophageal infarction and recurrence of arterial esophageal bleeding were observed during this study.ConclusionsTAE with NBCA can arrest bleeding in esophageal cancer patients with active arterial esophageal bleeding, even in those with a pre-existing coagulopathy.

Highlights

  • The aim of this study is to evaluate the clinical efficacy and safety of transcatheter arterial embolization (TAE) with N-butyl cyanoacrylate (NBCA) for the treatment of arterial esophageal bleeding in esophageal cancer patients

  • We report the clinical efficacy and safety of TAE with NBCA for treatment of arterial esophageal bleeding in esophageal cancer patients

  • Before TAE, enhanced computed tomography (CT) was performed in all patients

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Summary

Introduction

The aim of this study is to evaluate the clinical efficacy and safety of transcatheter arterial embolization (TAE) with N-butyl cyanoacrylate (NBCA) for the treatment of arterial esophageal bleeding in esophageal cancer patients. Esophageal cancer patients may suffer lethal esophageal artery bleeding [1]. With the advancement of technology, transcatheter arterial embolization (TAE) of the esophageal artery can be an effective alternative treatment [4,5,6,7]. It was reported that TAE was useful for the treatment of endoscopically unmanageable non-variceal upper gastrointestinal bleeding, and there was some possibility of rebleeding due to coagulopathy [8]. An advantage of TAE with NBCA is its high success rate of occlusion even in patients with a coagulopathy; there are disadvantages that NBCA could cause ischemic injury and is difficult to handle precisely [17]

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