13th Annual Global Embolization Symposium & Technologies
Purpose : To describe the most common clinical presentations, causes, variant embolization techniques, outcomes and complications encountered in pancreaticoduodenal arterial hemorrhage.
Material and Methods : A retrospective chart review of embolization performed for pancreaticoduodenal artery hemorrhage over the past four years at both Long Island Jewish and North Shore University Hospital was performed. Procedural success, immediate complications and clinical outcomes were recorded. Five of these cases were selected to highlight the variety of techniques and agents available to perform such a procedure. Images from these cases were de-identified and extracted from PACS.
Results : Retrospective chart review was performed for patients who had undergone embolization of the pancreaticoduodenal artery. Fourteen patients were identified who had embolizations for pancreaticoduodenal artery hemorrhage. The patient age range was 36-92 with a mean age of 64 years. The most common etiology was pancreatitis (42.9%) followed by idiopathic or unknown (21.4%). Embolization was performed with coils alone in 9 patients, coils plus microvascular plug in 2 patients, coils plus n-BCA glue in 2 patients, and n-BCA alone in 1 patient. Primary hemostasis was achieved in 11/14 (79%) patients with no immediate complications. Additional embolization was required to achieve hemostasis in 3/14 (21%) patients.
Conclusions : Pancreaticoduodenal Artery hemorrhage is a relatively uncommon source of gastrointestinal hemorrhage for which embolization is an elegant solution with primary hemostasis achieved in 79% of patients.