Major and minor complications of the pancreas after transcatheter arterial embolization using n-butyl-2-cyanoacrylate for acute bleeding from pancreatic arteries

Jpn J Radiol. 2022 Mar;40(3):308-317. doi: 10.1007/s11604-021-01203-8. Epub 2021 Oct 6.

Abstract

Purpose: The purpose is to investigate the major and minor complications of the pancreas after transcatheter arterial embolization (TAE) using n-butyl-2-cyanoacrylate (NBCA) for bleeding from pancreatic arteries.

Materials and methods: Thirty-three patients who underwent TAE using NBCA for acute bleeding from pancreatic arteries and their parent arteries followed by contrast-enhanced computed tomography (CE-CT) were evaluated retrospectively. Complications and risk factors were assessed using Mann-Whitney U test or Fisher's exact test for the univariate analysis. Patients' characteristic, embolized artery, procedure details, and clinical outcomes were examined as possible risk factors.

Results: TAE was performed successfully in all patients. Minor pancreatic complications occurred in 10 patients (30%), including acute mild pancreatitis (n = 4) and focal lack of pancreatic parenchymal enhancement on CE-CT without pancreatitis (n = 6). No cases of major pancreatic complications, such as moderate/severe pancreatitis, were reported. Embolized artery was the only significant risk factor. The rate of complications per embolized artery were 15% (three out of 20 patients) in the arteries of the pancreatic head and 54% (seven out of 13 patients) in the arteries of pancreatic body and tail (p = 0.025).

Conclusion: TAE using NBCA for acute bleeding from pancreatic arteries is efficacious and safe. Mild pancreatic complications were observed more frequently in case of embolization of the pancreatic body and tail region than the pancreatic head.

Keywords: N-butyl-2-cyanoacrylate; Pancreas; Pancreatic infarction; Pancreatitis; Transcatheter arterial embolization.

MeSH terms

  • Angiography
  • Arteries / diagnostic imaging
  • Embolization, Therapeutic* / methods
  • Enbucrilate* / therapeutic use
  • Humans
  • Pancreas / diagnostic imaging
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Enbucrilate