Current role of cyanoacrylate glue transcatheter embolization in the treatment of acute nonvariceal gastrointestinal bleeding

Expert Rev Gastroenterol Hepatol. 2020 Oct;14(10):975-984. doi: 10.1080/17474124.2020.1790355. Epub 2020 Jul 22.

Abstract

Introduction: Over the past three decades, transcatheter arterial embolization (TAE) has become the first-line therapy for the management of acute nonvariceal gastrointestinal bleeding (NVGIB) that is refractory to endoscopic hemostasis. Advances in catheter-based techniques and newer liquid embolic agents, as well as recognition of the effectiveness of minimally invasive treatment options, have expanded the role of interventional radiology in the treatment of acute NVGIB. Many embolic agents have been used successfully. However, no guidelines exist about the choice of the best embolic agent which is still controversial. Cyanoacrylate glue has gained acceptance over time. This article aims to address the current role of TAE using cyanoacrylate glue for the treatment of acute NVGIB.

Areas covered: The authors undertook a literature review of the current evidence on the use of cyanoacrylate glue in treating patients with acute NVGIB.

Expert opinion: The evidence shows that cyanoacrylate glue is the most clinically useful embolic agent in treating patients with acute NVGIB, despite the need for learning curve, especially in case of coagulopathy. At present, research is ongoing to assess liquid embolic agents in the treatment of patients presenting with acute NVGIB. More research is needed but cyanoacrylate glue show promise for the future.

Keywords: Acute nonvariceal upper gastrointestinal bleeding; cyanoacrylate glue; interventional radiology; lower gastrointestinal bleeding; transcatheter arterial embolization.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Adhesives*
  • Animals
  • Catheters
  • Contraindications, Procedure
  • Cyanoacrylates* / chemistry
  • Embolization, Therapeutic / adverse effects
  • Embolization, Therapeutic / methods*
  • Gastrointestinal Hemorrhage / therapy*
  • Humans
  • Patient Selection
  • Recurrence

Substances

  • Adhesives
  • Cyanoacrylates