Emergency Transcatheter Arterial Embolization for Acute Mediastinal Hemorrhage

Purpose The aim of this study was to investigate the application value of transcatheter arterial embolization (TAE) for mediastinal hemorrhage. Materials and Methods The study retrospectively analyzed the status of TAE treatment in 13 patients with mediastinal hemorrhage. Results Aortic angiography and bleeding artery angiography showed that the bleeding in 13 mediastinal hemorrhage patients, respectively, originated from intercostal artery, esophageal artery, or bronchial artery. All patients were embolized with gelatin sponge and (or) polyvinyl alcohol particles. Chest computed tomography scan found that all 13 patients showed reduced range of mediastinal hematoma after TAE. Conclusion TAE has the advantages of reduced trauma, rapid and direct hemostasis, and solid therapeutic effects in the treatment of mediastinal hemorrhage.

Transarterial Embolization of Acute Gastrointestinal Bleeding

Transarterial embolization (TAE) is a minimally invasive treatment method developed alternative to surgery for acute gastrointestinal bleeding (AGIB). The aim of this study was to evaluate the efficacy and outcome of TAE in AGIB patients. The data of 30 patients who underwent TAE with complaint of AGIB between January 2007- May 2020 was collected retrospectively. The etiology of hemorrhage, localization and type of lesion, embolizing agent used, and postprocedural complications were recorded. Lesions were classified as pseudoaneurysm (PA), extravasation, pathological tumor vascularity and vasospasm. A total of 22 patients, 5 females, were included in the study. The most common underlying cause was tumors (n=15, 50%). The most common lesion detected on angiograms was pathological tumor vascularity. Embolizing agents used were Nbutyl-2-cyanoacrylate in five patients, coils in three patients, polyvinyl alcohol particles in six patients and microsphere in seven patients. The technical success rate was 90.9%, and two patients developed rebleeding in the early postprocedural period. TAE is a safe, effective and minimally invasive method in emergency treatment of patients with AGIB.

Surgery Combined With Embolization in the Treatment of Plexiform Neurofibroma: A Case Report and Literature Review

Neurofibromatosis type 1 (NF1) is an autosomal dominant multisystem genodermatosis resulting from a mutation on chromosome 17q11.2, characterized by diverse clinical expression with involvement of the skin, nervous system, bones, eyes and other systems. Neurofibromas are tumors located along nerve bundles; when they become large, they are called plexiform neurofibromas. Complications of neurofibromas are rare, but include malignant transformation and potentially life-threatening hemorrhages. A comprehensive perioperative management, including arterial embolization of feeding vessels, is required in order to perform a safe surgical procedure and to reduce potential surgical complications. We report a case of a large plexiform neurofibroma on the right flank, treated in a two-stage approach: first, embolization with polyvinyl alcohol particles of the inferior epigastric, lumbar and superior gluteal arteries on the right and, second, 24 hours after embolization, exeresis of the lesion, which weighed 2.5 kg. Two years after surgery, the patient was asymptomatic, without tumor recurrence and with an important improvement in self-esteem and quality of life.