POLY(2-HYDROXYETHYL METHACRYLATE) PARTICLES FOR PREOPERATIVE ENDOVASCULAR OCCLUSION OF EXTENSIVE ANGIODYSPLASIAS

The application of superselective endovascular occlusion in vascular r adiology has broadened the scope of possible radical surgery of giant angiodysplasias by reducing considerably the risk of severe haemorrhag e during the surgery. Occlusion was performed on 229 patients using sp herical and cylindrical particles of porous poly(2-hydroxyethyl methac rylate). The treatment of a patient suffering from angiodysplasia of t he pelvis is described as an example. The first day following endovasc ular occlusion a hypercoagulation reaction developed, with a decrease of both the level of fibrinolysis and of anticoagulant factors. This w as mainly due to a decrease of the level of antithrombin III and activ ation of the factor XIII indicating a strong tendency of intravascular thrombosis. During the third day, the hypercoagulation reaction incre ased. However, on the fifteenth day, parameters of the haemostasis sys tem were close to normal values. Only the activity of the factor XIII remained high suggesting the stabilization and the organization of fib rin clot in the embolized blood vessel territory. (C) 1993 John Wiley & Sons, Inc.