Recanalization after Successful Occlusion by Transcatheter Arterial Embolization with N-Butyl Cyanoacrylate for Traumatic Splenic Artery Injury

Ishikawa Masaki

Kakizawa Hideaki

Yamasaki Wataru

Date Syuji

Hieda Masashi

Kajiwara Kenji

Awai Kazuo

Hiroshima Journal of Medical Sciences

[PISSN] 0018-2052

[EISSN] 2433-7668

[NCID] AA00664312

A 70-year-old male with advanced pancreatic cancer went into shock after sustaining a traumatic abdominal injury. Computed tomography (CT) showed a hematoma with extravasation around the pancreas and hemorrhagic ascites. After direct catheterization failed due to angiospasm, the ruptured splenic artery was successfully occluded by transcatheter arterial embolization (TAE) using an N-butyl cyanoacrylate (NBCA)-lipiodol mixture and the patient recovered from shock without complications. A follow-up CT obtained 20 days later showed a recurrent splenic artery pseudoaneurysm without extravasation. A repeat angiogram demonstrated recanalization of the splenic artery and pseudoaneurysm via antegrade. We embolized the recanalized pseudoaneurysm using metallic coils for isolation. Our experience indicates that adequate concentration and volume of the NBCA-lipiodol mixture should be considered depending on the vascular spasm in a patient with hypovolemic shock.

N-butyl cyanoacrylate

Recanalization

Splenic artery injury

Medical sciences [ 490 ]

eng

Hiroshima University Medical Press

(c) Hiroshima University Medical Press.

[ISSN] 0018-2052

[NCID] AA00664312