Gastrointestinal Intervention 2018; 7(3): 158-161  https://doi.org/10.18528/gii180030
Is glue embolization safe and effective for gastrointestinal bleeding?
Shinsaku Yata,* Yasufumi Ohuchi, Akira Adachi, Masayuki Endo, Shohei Takasugi, Kazumichi Tsukamoto, Kensuke Matsumoto, Mika Kodani, Jun Makishima, Shinya Fujii
Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Tottori, Japan
*Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, 36-1 Nishicho, Yonago, Tottori 683-8504, Japan.
E-mail address: yata-s@med.tottori-u.ac.jp (S. Yata). ORCID: https://orcid.org/0000-0002-1995-8054
Received: July 25, 2018; Revised: August 5, 2018; Accepted: August 5, 2018; Published online: October 31, 2018.
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cc This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Transcatheter arterial embolization using N-butyl-2-cyanoacrylate (NBCA) for gastrointestinal arterial bleeding enables higher cessation rate and lower recurrent bleeding rate compared with conventional embolic materials including gelatin sponge, metallic coil, and polyvinyl alcohol (PVA) particle. Glue embolization is particularly effective in patients with coagulopathy. Even in the lower gastrointestinal tract, ischemic bowel complications by glue embolization are comparable to other agents. Glue embolization is also effective for arterial esophageal bleeding without any serious ischemic complications although the anatomy of the esophageal artery is complex and varied. For bleeding after abdominal surgery such as pancreaticoduodenectomy or hepatic lobectomy, interventional radiologists should be careful with indicating glue embolization because the presence of fewer collateral vessels can easily result in serious ischemic complications. Modified glue such as Glubran 2 (NBCA associated with methacryloxyfulfolane) can reduce the risk of ischemic complication due to its less thermal reaction, but the outcomes seem unsatisfactory.
Keywords: Cyanoacrylates; Gastrointestinal hemorrhage; Therapeutic embolization


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