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 Collagen nanofibrils in mammalian tissues get stronger with exercise
14.12.2018 | University of Illinois College of Engineering

nachricht New discoveries predict ability to forecast dementia from single molecule
12.12.2018 | UT Southwestern Medical Center

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: Data storage using individual molecules

Researchers from the University of Basel have reported a new method that allows the physical state of just a few atoms or molecules within a network to be controlled. It is based on the spontaneous self-organization of molecules into extensive networks with pores about one nanometer in size. In the journal ‘small’, the physicists reported on their investigations, which could be of particular importance for the development of new storage devices.

Around the world, researchers are attempting to shrink data storage devices to achieve as large a storage capacity in as small a space as possible. In almost...

Im Focus: Data use draining your battery? Tiny device to speed up memory while also saving power

The more objects we make "smart," from watches to entire buildings, the greater the need for these devices to store and retrieve massive amounts of data quickly without consuming too much power.

Millions of new memory cells could be part of a computer chip and provide that speed and energy savings, thanks to the discovery of a previously unobserved...

Im Focus: An energy-efficient way to stay warm: Sew high-tech heating patches to your clothes

Personal patches could reduce energy waste in buildings, Rutgers-led study says

What if, instead of turning up the thermostat, you could warm up with high-tech, flexible patches sewn into your clothes - while significantly reducing your...

Im Focus: Lethal combination: Drug cocktail turns off the juice to cancer cells

A widely used diabetes medication combined with an antihypertensive drug specifically inhibits tumor growth – this was discovered by researchers from the University of Basel’s Biozentrum two years ago. In a follow-up study, recently published in “Cell Reports”, the scientists report that this drug cocktail induces cancer cell death by switching off their energy supply.

The widely used anti-diabetes drug metformin not only reduces blood sugar but also has an anti-cancer effect. However, the metformin dose commonly used in the...

Im Focus: New Foldable Drone Flies through Narrow Holes in Rescue Missions

A research team from the University of Zurich has developed a new drone that can retract its propeller arms in flight and make itself small to fit through narrow gaps and holes. This is particularly useful when searching for victims of natural disasters.

Inspecting a damaged building after an earthquake or during a fire is exactly the kind of job that human rescuers would like drones to do for them. A flying...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

ICTM Conference 2019: Digitization emerges as an engineering trend for turbomachinery construction

12.12.2018 | Event News

New Plastics Economy Investor Forum - Meeting Point for Innovations

10.12.2018 | Event News

EGU 2019 meeting: Media registration now open

06.12.2018 | Event News

 
Latest News

Pressure tuned magnetism paves the way for novel electronic devices

18.12.2018 | Materials Sciences

New type of low-energy nanolaser that shines in all directions

18.12.2018 | Physics and Astronomy

NASA research reveals Saturn is losing its rings at 'worst-case-scenario' rate

18.12.2018 | Physics and Astronomy

VideoLinks
Science & Research
Overview of more VideoLinks >>>