No embolization-related complications, including transient liver dysfunction, development of liver infarction, and dislodgement of coils, were observed. Nineteen (49 per cent) were managed using transarterial embolization (TAE) of the GDA via the common hepatic artery (CHA), and 14 (36 per cent) by selective embolization of the pseudoaneurysm. Acute pancreatitis is a rare complication of TACE. Methods: Accessibility This site needs JavaScript to work properly. 2011 Feb;34(1):74-80. doi: 10.1007/s00270-010-9845-7. National Library of Medicine Fifty patients stratified for SIRT were prospectively randomized for embolization of the GDA with either coils or the AVP II. In 16 pseudoaneurysms, the sandwich or exclu ‑ 2016 Apr-Jun;26(2):254-61. doi: 10.4103/0971-3026.184422. Results: Secondary end points included complete duration of the intervention, amount of contrast medium used, fluoroscopy rates, and adverse effects. Privacy, Help 2 Endovascular embolization using coils is an alternative modality to endoscopic hemostasis in managing upper gastrointestinal (UGI) bleeding, especially for VAA and VAAs pseudoaneurysms in hemodynamically stable patients. Conclusion: GDA origin recanalization after fibered coil occlusion is common. Temperature-induced configuration changes in hydrogel-coated coils and their relevance in embolization procedures. Transarterial embolization Introduction Selective internal radiotherapy (SIRT) is a promising therapy for palliation in primary and secondary liver tumors [1–5]. In all cases, the GDA was successfully occluded with only one HydroCoil. Prevention and treatment information (HHS). Early surgical complications include anastomotic leak, hemorrhage, sepsis, pancreaticojejunal fistula, acute pancreatitis of the remnant pancreas, and peritonitis [1, 2]. Wang W, Li H, Tam MD, Zhou D, Wang DX, Spain J. Cardiovasc Intervent Radiol. Protective occlusion of the gastroduodenal artery (GDA) is frequently required before radioembolization because extrahepatic embolization (nontarget embolization) of yttrium-90 microspheres may lead to severe adverse effects and complications. No further site of active bleeding identified. Inadvertent embolization of the CHA can result despite the dual blood supply of the liver to multiple complications, ranging from subtle elevation of the liver enzymes all the way up to hepatic infarction and even acute hepatic failure (Aina et al. eCollection 2018. the well‑recognized major complications of GDA embolization include duodenal ischemia and hepatic infarction from nontarget embolization. In the short term, accidentalembolization of the wrong vessel with ensuing infarction is may be the most serious complication. Postoperative liver infarction developed only in 8 patients (25.8%) even though 7 of 8 patients had undergone preoperative coil embolization. Cardiovasc Intervent Radiol. No further complications identified. Familiarity with this phenomenon is beneficial to reduce the likelihood of gastrointestinal tract complications during hepatic locoregional therapy. Embolization of the gastroduodenal artery before selective internal radiotherapy: a prospectively randomized trial comparing standard pushable coils with fibered interlock detachable coils. Epub 2013 Apr 30. The mean diameter of the GDA was 3.7 mm (range, 2.2-4.8 mm) for both groups. The primary end point was to achieve a proximal occlusion of the GDA with only one detachable HydroCoil. No 30-day mortality occurred in any of the patients. Privacy, Help Vessel reperfusion was noted in only one patient, in whom coil embolization was performed. Purpose: Embolization of liver tumors: Past, present and future. Arterial blood flow in the liver was also clearly detected on MDCT after the embolization, although precise evaluation of blood flow of the CHA was difficult due to an artifact of coils. Epub 2013 Jul 11. Evaluated parameters were duration of deployment, and early (during the intervention) and late (7-21 days) occlusion rates of GDA. In both cases the plug could not be positioned due to the small celiac trunk outlet angles of 17 degrees and 21 degrees. For this procedure protective artificial occlusion of the gastroduodenal artery (GDA) is required beforehand because extrahepatic embolization of yttrium- Superiority of proximal embolization of the gastroduodenal artery with the Amplatzer vascular plug 4 before yttrium-90 radioembolization: a retrospective comparison with coils in 134 patients. The procedures differed significantly in fluoroscopy time (7.8 min for coils vs. 2.6 min for the AVP II; P < 0.001) and embolization time (23.1 min for coils vs. 8.8 min for the AVP II; P < 0.001). Yttrium-90 radioembolization treatment for unresectable hepatocellular carcinoma: a single-centre prognostic factors analysis. However, approximately 5% of the patients that … 2013 Sep;54(7):790-4. doi: 10.1177/0284185113481696. Other suspected causes are the use of glue or gelatin sponge powder alone [ 4 ]. FOIA Inferior Pancreatoduodenal Artery Aneurysm Inferior pancreatoduodenal artery aneu-rysm is rarely seen after the Whipple proce-dure but is presumed to occur as the result of increased flow in the inferior pancreatoduo-denal artery after GDA ligation (Fig. Rammohan A, Sathyanesan J, Ramaswami S, Lakshmanan A, Senthil-Kumar P, Srinivasan UP, Ramasamy R, Ravichandran P. World J Radiol. Hur et al compared two embolization techniques in the treatment of GDA stumps and concluded that the rupture rate of the pseudoaneurysm treated by the packing technique (selective embolization of the GDA stump and/or pseudoaneurysm sparing hepatic arterial flow) was higher than that of the sandwich technique (embolization of the hepatic artery proximal and distal to the GDA stump). 2015 Dec;32(4):356-69. doi: 10.1055/s-0035-1564810. Rare complication after GDA embolization After embolization of Splanchnic artery aneurysms, some complications could occur. 2012 Sep 28;4(9):405-12. doi: 10.4329/wjr.v4.i9.405. Embolization of the gastroduodenal artery before selective internal radiotherapy: a prospectively randomized trial comparing standard pushable coils with fibered interlock detachable coils. Embolotherapy of the gastroduodenal artery (GDA) is essential before internal radiotherapy (SIRT) in order to prevent radiation-induced peptic ulcerations due to migration of yttrium-90 microspheres. He survived without any recurrence of cancer and bleeding. Postpancreatectomy Hemorrhage 8600 Rockville Pike Diagnosis and treatment of ruptured GDA pseudo-aneurysms rely on angiography. In conclusion, embolization of the GDA with the AVP II is safe, easy, rapid, and highly effective; only an extremely sharp-angled celiac trunk outlet represented an anatomical limitation for device deployment. These collaterals are reported to have been found in up to 44% of patients, after the GDA occlusion . Zabicki B, Limphaibool N, Holstad MJV, Juszkat R. PLoS One. Bleeding, secondary to the rupture of these lesions, is a serious complication that could lead to death. This makes it difficult to evaluate the complications from selective GDA embolization, as the high complication rate in group B might be secondary to ischemia from recurrent bleeding or from subsequent endovascular trapping. National Library of Medicine Endovascular management of pancreatitis-related pseudoaneurysms: A review of techniques. The major complications that occur after transarterial embolization are ischemia, duodenal stenosis, and infarction, with rates varying from 0.04 to 9 % [ 4, 5, 11, 12 ]. 8600 Rockville Pike Accessibility 4. coil and plug embolization of the gastroduodenal artery. The purpose of this study was to compare the vascular anatomical limitations, procedure time, effectiveness, and safety of embolization of the GDA with coils versus the AVP II. The distance between the GDA origin and most cephalad coil appears to be a predisposing factor for recanalization. 3. selective and subselective angiography of the hepatic arteries including common, proper, right and left hepatic angiograms. Rare complication after GDA embolization After embolization of Splanchnic artery aneurysms, some complications could occur. 2013 Sep;54(7):790-4. doi: 10.1177/0284185113481696. [2,5,8,9] We report a 2014 Dec 1;7:425-36. doi: 10.2147/MDER.S49540. Bethesda, MD 20894, Copyright GDA originated from CHA in 98% while directly originating from the CA, RHA or LHA in less than 2% of cases. A Systematic Review. It has been shown to be safe and similar in efficacy compared to targeted endovascular embolization. Hydrogel-Coated Coils: Product Description and Clinical Applications. Ischemic complications were as splenic infarctions , bowel ischemia, and perforation . 6). One of the complications of GDA embolization is reopening of coiled or even newly developed hepatointestional collaterals. Clipboard, Search History, and several other advanced features are temporarily unavailable. 3 However, coil migration can occur as a complication. Fifty patients stratified for SIRT were prospectively randomized for embolization of the GDA with either coils or the AVP II. The bleeding stopped, and no ischemic complications were reported. The angle between the aorta and the celiac trunk, diameter of the GDA, fluoroscopy time and total time for embolization, number of embolization devices, complications, and durability of vessel occlusion at follow-up angiography for SIRT were recorded. Lopez Benitez R, Reyes Del Castillo T, Kara L, Kettenbach J, Roos J. CVIR Endovasc. Besides the known complication of duodenal ischaemia, pancreatitis is another possible complication with GDA embolization and probably patients in ESRD are more susceptible for this complication. Bethesda, MD 20894, Copyright In 21 (91%) of 23 patients, a complete occlusion of the GDA was achieved during the first 30 min after the coil implantation; however, in all patients, a late occlusion of the GDA was present after 6 to 29 days. For this purpose, different materials, including micro- In the current study, embolization was performed to the stomach and small bowel without any ischemic complications. Weber CH, Pfeifer KJ, Tato F, Reiser M, Rieger J. Cardiovasc Intervent Radiol. A mean of 6.0 +/- 3.2 coils were used for GDA embolization, while no more than one AVP II was needed for successful vessel occlusion (P < 0.001). artery to as many branches of the GDA as possible to prevent ischemic complications. Bulla K, Hubich S, Pech M, Löwenthal D, Ricke J, Dudeck O. Cardiovasc Intervent Radiol. Foci of active bleeding via branches of the GDA. The selected diameter/length range was 4/10 mm in 2 patients, 4/15 mm in 6 patients, and 4/20 mm in 15 patients. Clipboard, Search History, and several other advanced features are temporarily unavailable. In the majority of these cases, the SIRT could still be performed with the recoiling or modification of the microcatheter position. Superiority of proximal embolization of the gastroduodenal artery with the Amplatzer vascular plug 4 before yttrium-90 radioembolization: a retrospective comparison with coils in 134 patients. A t-test was used for statistical analysis. Balloon-assisted coil embolization of intracranial aneurysms is associated with a high complication rate and should only be used if conventional CE of these lesions is impossible or has failed and if anticipated surgical risks are too high. Radioembolization: Is Prophylactic Embolization of Hepaticoenteric Arteries Necessary? Unable to load your collection due to an error, Unable to load your delegates due to an error. In the … tion for proximal GDA pseudo-aneurysms [4] and should be considered if angiographic embolization fails or is un-available or contraindicated [15, 16]. eCollection 2014. 2001 ). Epub 2017 Nov 7. Temperature-induced configuration changes in hydrogel-coated coils and their relevance in embolization procedures. [3,4,5,6,7] Although uncommon, the well-recognized major complications of GDA embolization include duodenal ischemia and hepatic infarction from nontarget embolization. Complications associated with TAE may arise from non-targeted embolization and the usage of small-sized embolic particles (less than 250 μm) . One coil migration occurred during coil embolization, whereas no procedural complication was encountered with the use of the AVP II. Semin Intervent Radiol. Bulla K, Hubich S, Pech M, Löwenthal D, Ricke J, Dudeck O. Cardiovasc Intervent Radiol. Tumor contact with the gastroduodenal artery (GDA)/proper hepatic artery (PHA) on preoperative multi-detector computed tomography (MDCT), tumor size, operative time, portal vein resection, and stenosis of the GDA… 1). The amplatzer vascular plug: a review of the device and its clinical applications. Empiric embolization of the GDA in patients more » 2011 Feb;34(1):74-80. doi: 10.1007/s00270-010-9845-7. 2020 Dec 10;3(1):96. doi: 10.1186/s42155-020-00189-0. Gastroduodenal artery recanalization after transcatheter fibered coil embolization for prevention of hepaticoenteric flow: incidence and predisposing technical factors in 142 patients. embolization, potential second-line treatments including hepatic artery covered-stent placement and terminal hepatic artery embolization. Embolizations with either coils or the AVP II were technically feasible in all but two patients scheduled for embolization of the GDA with the AVP II. 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