ESTIMATION OF USEFULNESS OF N-BUTYL-2-CYANOACRYLATE-LIPIODOL MIXTURE IN TRANSCATHETER ARTERIAL EMBOLIZATION FOR URGENT CONTROL OF LIFE-THREATENING MASSIVE BLEEDING FROM GASTRIC OR DUODENAL-ULCER

We estimated the usefulness of a mixture of N-butyl-2-cyanoacrylate (N BCA) with lipiodol for transcatheter arterial embolization (TAE) used to control massive bleeding from gastric or duodenal ulcer. Thirty pat ients who had gastric or duodenal ulcers and massive bleeding that was uncontrollable by endoscopic procedures were included in this study. All patients were subjected to TAE (without NBCA in 23 and with NBCA i n seven patients). Coils and/or gelfoam were also used. The achievemen t of haemostasis, occurrence of rebleeding and the time taken for TAE were compared between patients who received TAE without and with NBCA. Eighteen of 23 patients (78.3%) who received TAE without NBCA and six of seven patients (85.7%) who underwent TAE with NBCA achieved comple te haemostasis without rebleeding. The time for TAE was significantly shorter in patients who received NBCA compared with those who did not (P = 0.0095). TAE using NBCA or a combination of NBCA and coils achiev ed a rapid, complete embolization regardless of vascular distribution or arterial diameter. Thus NBCA is considered to be useful as a second ary embolization material in TAE that is urgently conducted to control massive bleeding from gastric or duodenal ulcers.