Superselective transcatheter arterial embolization in patients with acute peripancreatic bleeding complications: review of 44 cases

Purpose To evaluate the efficacy of superselective transcatheter arterial embolization (TAE) in the treatment of acute peripancreatic bleeding complications. Methods During a 9-year period, 44 patients with acute bleeding of the peripancreatic arteries underwent TAE in our institution. Thirty-eight patients were treated using microcatheters and 6 patients with a diagnostic catheter. Embolic agents included coils ( n = 38), polyvinyl alcohol (PVA) particles ( n = 2), isobutyl cyanoacrylate ( n = 2), coils plus PVA particles ( n = 1), and coils plus isobutyl cyanoacrylate ( n = 1). Outcome measures included technical success, clinical success, and the rate of complications. Results Identified bleeding sources included gastroduodenal artery ( n = 14), splenic artery ( n = 9), pancreaticoduodenal artery ( n = 6), common hepatic artery ( n = 5), superior mesenteric artery branches ( n = 4), proper hepatic artery ( n = 3), and dorsal/transverse pancreatic artery ( n = 3). Technical success with effective control of active bleeding was achieved in 41/44 patients (93 %). Clinical success attributed to TAE alone was documented in 40/44 patients (91 %). The rate of major complications was 2 % including death in one patient. Conclusions Superselective TAE allows effective, minimally invasive control of acute peripancreatic bleeding complications with a low rate of therapeutically relevant complications.