[Embolization in peripheral artery bleeding with Onyx].

OBJECTIVE

This study describes use of ethylene vinyl alcohol copolymer (EVOH) dissolved in anhydrous dimethyl sulfoxide (DMSO) and mixed with tantalum powder to achieve radiopacity as an effective, safe, and manageable embolic agent in endovascular treatment of artery haemorrhages.

METHODS

Twenty patients with pseudoaneurysms secondary to biopsy, or surgery were treated, 11 musculoskeletal arteries, 9 visceral (4 gastroduodenal arteries). A diagnostic angiographic procedure that showed the artery lesion was always performed. Embolization was performed immediately, followed by post-embolization angiographic control. Transcatheter embolization was always performed, using a coaxial system consisting of a 4F hydrophilic guide catheter with 0.038" diameter, a microcatheter compatible with DMSO administration (Rebar microcatheter), and a microguide. All cases progressed with acute hemorrhagic syndrome of variable intensity. There were nine cases with hemorrhagic shock.

RESULTS

All cases were satisfactorily resolved without recurrence of bleeding during follow-up.

CONCLUSIONS

Our experience with selective embolization of spontaneous or traumatic artery bleeding with Onyx has been excellent due to its simple, rapid, and safe use.