SIR 2024
Embolization
Bilal Arif, MD
Interventional Radiologist- In Training
Albany Medical Center
Financial relationships: Full list of relationships is listed on the CME information page.
Faraz Khan, MD
Interventional Radiologist
Albany Medical Center
Disclosure information not submitted.
Pagah Naeimi, MD
Interventional Radiologist
Albany Medical Center
Disclosure information not submitted.
Christopher Stark, MD
Interventional Radiologist
Albany Medical Center
Disclosure information not submitted.
Gary Siskin, MD (he/him/his)
Professor and Chairman, Department of Radiology
Albany Medical Center
Disclosure information not submitted.
To evaluate the safety and efficacy of combination embolic therapy using the OnyxTM Liquid Embolic System (Medtronic Corp., Minneapolis MN) and detachable coils for the treatment of acute peripheral arterial hemorrhage.
Materials and methods:
The study population for this single-center study was determined by searching an institutional database to find patients who underwent combination embolic therapy with OnyxTM and detachable coils to treat acute peripheral arterial hemorrhage. A retrospective review of the medical record was then performed to assess the patient characteristics, procedural details and primary outcome measures including technical success (defined as no angiographic evidence of bleeding after embolization) and clinical success (defined as absence of bleeding from the target lesion after embolization without the need for surgery, re-embolization, or other interventions within 30 days). Secondary endpoints included all-cause mortality and adverse event rates at 30 days.
Results:
The study population consisted of 37 patients (mean age of 49.0 years; 45.9% Female and 54.1% Male). The comorbidities within this patient population included hypertension (51.4%), hyperlipidemia (35.10%), atrial fibrillation (21.6%), diabetes (18.9%) and cancer (18.9%). The targeted areas of hemorrhage included upper GI (32.4%), splenic (13.5%), renal (10.8%), pelvic (13.5%), thoracic (8.1%), extremity (5.4%), and other (16.3%). All patients underwent embolization using OnyxTM in combination with detachable coils. The mean number of coils used was 4.0 and the mean number of OnyxTM vials opened was 1.2 (1 vial in 86.5%, 2 vials in 10.8%, and 3 vials in 2.7%). The technical success rate was 97.3% (n = 36/37) and the clinical success rate at 30 days was 91.9% (n = 34/37). Reintervention occurred in 8.1% of patients (n = 3/37) including one patient with a small residual rectal bleed seen on post-embolization angiography. There were no reported adverse events. The all-cause mortality rate at 30 days was 16.2% (n = 6/37) including one patient with ongoing bleeding.
Conclusion:
Combination embolic therapy using the OnyxTM Liquid Embolic System and detachable coils is safe and effective for the treatment of acute peripheral arterial hemorrhage.