Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Glue Shows Promise for Acute Arterial Hemorrhage

14.07.2004


Catheter-directed embolization is a well-established interventional radiology technique used to treat arterial hemorrhage in a variety of areas in the body. Although embolization has been used for over 20 years to treat trauma victims with massive bleeding and to control hemorrhage after childbirth instead of emergency hysterectomy, the investigation of glue as an embolic agent is new. Embolization is particularly useful because in massive bleeding often there is so much blood coming at the surgeon that it is impossible for the surgeon to see the bleeding site from the outside in order to repair it. Since the interventional technique uses X-rays to visualize the inside of the vessel, the hemorrhage does not interfere with visualization and the interventional radiologist can pinpoint the location of the injury for embolization. In this minimally invasive treatment, a tiny nick is made in the skin and, using imaging, the interventional radiologist guides a catheter through the artery then releases clotting agents – coils or particles-- into the blood vessels. This slows the blood flow and stops the hemorrhage from the inside out. Most often coils or small particles are used as the embolic agent. These are effective in most cases, but there are times when these forms of embolization may not be technically possible. In this study, embolization with the glue, NBCA, successfully stopped arterial bleeding even when previous coil or particle embolization had failed. NBCA was useful in a large number of anatomic locations alone or in combination with other embolic agents, particularly microcoils.



N-butyl cyanoacrylate (NBCA) is a permanent liquid embolic material and tissue adhesive that is approved by the U.S. Food and Drug Administration for use in cerebral arteriovenous malformations. This article summarizes the initial experience with NBCA glue embolization in 16 patients with acute arterial hemorrhage. NBCA embolization was successful in 75 percent of the patients and failed in 12.5 percent in this study at the Los Angeles County and University of Southern California Medical Center.

About Transcatheter Embolization, Choice of Agent, and Possible Role for NBCA


Most often, metallic coils or particles are used as the embolic agents for controlling arterial hemorrhage. These methods, although effective in the majority of cases, fail to achieve adequate hemostasis in some cases. Embolization may be ineffective as a result of inability to adequately reach the bleeding site, undesirable collateral blood flow to the bleeding site, reopening of the embolized vessels, or underlying clotting pathologies.

Major considerations for choosing an embolic occluding agent are speed and reliability of delivery, duration of occlusive effect, and preservation of normal tissue. Coils are ideal for single vessel injuries, larger vessels, or cases in which the site of vessel occlusion must be precise. They provide controlled delivery with rapid occlusion and are available in a wide variety of sizes. However, embolization with coils requires placement of a catheter or microcatheter at the bleeding site. This is not always possible as a result of small vessel size or tortuous blood vessels, i.e. vessels with repeated twists and bends. In cases of multiple lesions, distal location, or lesions supplied by numerous collateral (accessory) blood pathways, particles are used. Although particles can be administered from a catheter tip central to a lesion, their placement is not precise and may be difficult to deliver through small microcatheters or through tortuous anatomy. In addition, the particles themselves are not radiopaque, making exact documentation via X-ray of their site of occlusion impossible.

Benefits of NBCA as an Embolic Agent

Liquid embolic agents offer the advantages of low viscosity for easy injection through small catheters or catheters with many bends through tortuous blood vessels. NBCA is a liquid embolic agent with distinct advantages as an embolic material. Although NBCA can pass through bent catheters navigating tortuous blood vessels, it does not permeate all the way to the capillary level, and therefore does not cause tissue death.

Another distinct advantage of NBCA compared with particles is its dense radiopacity. Thus, its exact site of occlusion can be observed and documented. Nontarget embolization can be identified immediately and corrected. In addition, NBCA can successfully occlude the vessel in patients with clotting pathologies. This characteristic decreases the risk of organ ischemia, i.e. subsequent deprivation of oxygen and blood flow to the organ, which could cause tissue death in the organ. For example, in embolization of the bowel, ischemia is of concern because of limited additional accessory blood flow. In this case, NBCA may be the preferred embolic agents, and this is a worthy area for further study.

| newswise
Further information:
http://www.sirweb.org
http://www.jvir.org

More articles from Health and Medicine:

nachricht 'Living bandages': NUST MISIS scientists develop biocompatible anti-burn nanofibers
16.02.2018 | National University of Science and Technology MISIS

nachricht New process allows tailor-made malaria research
16.02.2018 | Eberhard Karls Universität Tübingen

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Demonstration of a single molecule piezoelectric effect

Breakthrough provides a new concept of the design of molecular motors, sensors and electricity generators at nanoscale

Researchers from the Institute of Organic Chemistry and Biochemistry of the CAS (IOCB Prague), Institute of Physics of the CAS (IP CAS) and Palacký University...

Im Focus: Hybrid optics bring color imaging using ultrathin metalenses into focus

For photographers and scientists, lenses are lifesavers. They reflect and refract light, making possible the imaging systems that drive discovery through the microscope and preserve history through cameras.

But today's glass-based lenses are bulky and resist miniaturization. Next-generation technologies, such as ultrathin cameras or tiny microscopes, require...

Im Focus: Stem cell divisions in the adult brain seen for the first time

Scientists from the University of Zurich have succeeded for the first time in tracking individual stem cells and their neuronal progeny over months within the intact adult brain. This study sheds light on how new neurons are produced throughout life.

The generation of new nerve cells was once thought to taper off at the end of embryonic development. However, recent research has shown that the adult brain...

Im Focus: Interference as a new method for cooling quantum devices

Theoretical physicists propose to use negative interference to control heat flow in quantum devices. Study published in Physical Review Letters

Quantum computer parts are sensitive and need to be cooled to very low temperatures. Their tiny size makes them particularly susceptible to a temperature...

Im Focus: Autonomous 3D scanner supports individual manufacturing processes

Let’s say the armrest is broken in your vintage car. As things stand, you would need a lot of luck and persistence to find the right spare part. But in the world of Industrie 4.0 and production with batch sizes of one, you can simply scan the armrest and print it out. This is made possible by the first ever 3D scanner capable of working autonomously and in real time. The autonomous scanning system will be on display at the Hannover Messe Preview on February 6 and at the Hannover Messe proper from April 23 to 27, 2018 (Hall 6, Booth A30).

Part of the charm of vintage cars is that they stopped making them long ago, so it is special when you do see one out on the roads. If something breaks or...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

2nd International Conference on High Temperature Shape Memory Alloys (HTSMAs)

15.02.2018 | Event News

Aachen DC Grid Summit 2018

13.02.2018 | Event News

How Global Climate Policy Can Learn from the Energy Transition

12.02.2018 | Event News

 
Latest News

Fingerprints of quantum entanglement

16.02.2018 | Information Technology

'Living bandages': NUST MISIS scientists develop biocompatible anti-burn nanofibers

16.02.2018 | Health and Medicine

Hubble sees Neptune's mysterious shrinking storm

16.02.2018 | Physics and Astronomy

VideoLinks
Science & Research
Overview of more VideoLinks >>>