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Abstract Objective: To determine the efficacy of Uterine Artery Embolization in patients with bleeding acquired uterine arteriovenous malformations (AVMs). Methods: A prospective review of all patients who underwent Uterine Artery Embolization at our institution between July 2015 and April 2022 was performed. 225 patients were diagnosed with a uterine vascular malformation on doppler and corresponding MRI imaging. All patients underwent transcatheter embolization of the uterine arteries. Embolic agents in the 375 procedures included Histoacryl glue only (n = 326), polyvinyl alcohol (PVA) particles and Histoacryl glue (n = 29), PVA particles (n = 5), Gelfoam (n = 5), coils (n = 4), PVA particles and coils (n = 3), Histoacryl glue and Gelfoam (n = 2), and Histoacryl glue and coils (n = 1). Results: A total of 375 embolization procedures were performed in 225 patients. 90 patients required repeat embolization for recurrence of bleeding. The technical success rate of embolization was 100%. The clinical success rate was 92%: bleeding was controlled in 222 of 225 patients and three patients underwent a hysterectomy. 60 of the 225 patients had uneventful intrauterine pregnancies carried to term. The 210 patients who underwent successful embolization had no recurrence of bleeding at a median follow-up of 53 months (range, 5-122 months) after treatment. 15 patients were eventually lost to follow-up. One minor complication (0.4%) of non-flow-limiting dissection of the internal iliac artery occurred. Conclusion: Uterine Artery Embolization is a safe, effective, minimally invasive method to treat uterine AVMs with long-term efficacy, which can provide the preservation of fertility.
Subject(s)
Humans , Female , Uterus , Enbucrilate , Uterine Artery Embolization , Endovascular Procedures , IndiaABSTRACT
Objective:To investigate the efficacy of endoscopic histoacryl injection in cirrhotic patients with newly-developed esophagogastric varices (EGV) who have previously undergone splenectomy combined with pericardial devascularization.Methods:From January 2015 to January 2020, 125 cirrhotic patients with EGV treated with endoscopic histoacryl injection at the Department of Gastroenterology, Jinling Hospital, Medical School of Nanjing University, were included in the retrospective analysis. There were 45 patients in the group of splenectomy combined with pericardial devascularization (splenectomy group for short) and 80 patients in the non-splenectomy group. The efficacy of endoscopic treatment, postoperative variceal improvement, rebleeding rate, and complications were analyzed between the two groups.Results:Endoscopic histoacryl injection was successfully completed in all 125 patients, and the median volume of histoacryl was 4.5 mL. The overall effective rate in splenectomy and non-splenectomy group was 80.0% (36/45) and 57.5% (46/80), respectively. The difference in the number of significantly effective, effective, and ineffective cases between the two groups was statistically significant (16, 20, 9 cases, and 20, 26, 34 cases, respectively, χ 2=6.469, P=0.039). Two and 14 patients developed rebleeding in the splenectomy group and non-splenectomy group, respectively; and the difference in the rebleeding rate between the two groups was statistically significant (4.4% VS 17.5%, Log-rank P=0.039). No patient died within 1 year in either group, and no serious complications such as ectopic embolism occurred. Conclusion:After splenectomy combined with pericardial devascularization in cirrhotic patients with EGV and hypersplenism, the application of histoacryl has better short-term efficacy and can significantly reduce the rebleeding rate compared with the non-splenectomy group.
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Objective To evaluate the clinical efficacy of absolute ethanol combined with histoacryl sclerotherapy in treating high-reflux venous malformation in children.Methods The clinical data of a total of 339 sick children with venous malformation,who were admitted to authors' hospital during the period from April 2009 to April 2014 to receive interventional sclerotherapy under general anesthesia,were retrospectively analyzed.Sclerotherapy with absolute ethanol combined with N-butyl cyanoacrylate (NBCA) was carried out in 137 sick children with high-reflux type venous malformation.The patients were followed up for 6-24 months (mean of 15 months).Results Successful sclerotherapy with absolute ethanol combined with NBCA was achieved in all 137 sick children with high-reflux type venous malformation.Complete cure was obtained in 23 sick children,basic cure in 31 sick children,and effective response (improvement) in 42 sick children;the total effective rate was 70％ (96/137).Ectopic embolization due to reflux of NBCA occurred in one sick child,skin ulceration was seen in 8 sick children and intraoperative transient pulmonary hypertension was observed in 3 sick children.The adverse reaction rate was 8％(12/137).Conclusion For the treatment of high reflux venous malformation in children,sclerotherapy with absolute ethanol plus NBCA is safe and effective,this technique carries low incidence of adverse reactions.(J Intervent Radiol,2017,26:217-220)
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Objective To compare the effect of the tissue adhesive Histoacryl and traditional suturing treatment on the cracked wounds on children's craniofacial skin. Methods About 152 children patients with cracked wounds children's craniofacial skin from March 2015 to June 2015 were divided into two groups according to their parents' will. Group A, with 77 patients, was treated by the tissue adhesive Histoacryl and Group B, with 75 patients, was treated by traditional suturing. The two groups were compare in terms of the treatment time and effect. Result The treatment time of Group A was significantly shorter than that of Group B (P0.05). Conclusions Compared to the traditional suturing, the tissue adhesive Histoacryl is advantageous, for its easy operation, short treatment time, prominent efficacy and beautiful appearance. Moreover, it can relieve the pain of children during the treatment.
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Objective To summarize clinical experience and explore application value of endoscopic clipping with histoacryl using in management of type 2 gastroesophageal varices. Methods Clinical data of 30 patients with type 2 gastroesophageal varices patients (including acute hemorrhage and primary prevention) from May 2015 to December 2016 were collected. Then evaluate therapeutic effect and safety of endoscopic clipping adjuvant therapy. Results Average glue dosage was (1.46 ± 0.70) ml, average using of clips were (5 ~ 6), and intraoperative needle pulling hemorrhage occurred in 2 cases. 14 patients (46.7%) underwent endoscopic re-examination, 3 patients (10.0%) achieved varicose vein elimination, 11 cases (36.7%) remained residual. Rebleeding occurred in 4 cases (13.3%), and 2 cases died (6.7%), one because of postoperative hematemesis and hemorrhagic shock, the other one died of spontaneous peritonitis and septic shock. For general curative effect, 2 cases (6.7%) were healed, 22 cases (73.3%) were improved, and 6 cases were unhealed (20.0%, 4 cases occurred rebleeding, 2 cases died); 17 cases underwent CT portal venograpy, abnormal embolization was not found in any patients, glue extrusion bleeding occurred in 1 case (3.3%), no patients had severe postoperative complications. Conclusion Endoscopic clipping with histoacryl can be used in the prevention and treatment of type 2 gastroesophageal varices to improve the treatment effect and reduce postoperative bleeding risk, may have good clinical practice value.
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Objective To investigate the safety and efficacy of endoscopic tissue adhesive injection combined with sequential endoscopic variceal ligation for gastroesophageal varices of Le,g type. Methods Twenty-three patients with gastroesophageal varices of Le,g type were enrolled to General Hospital of PLA from May 2013 to March 2015, who were treated with endoscopic tissue adhesive injection in the fundic and cardiac site in the first session, followed with endoscopic variceal ligation for esophageal varices. The clinical data, procedure complications and efficacy were retrospectively analysed. Results All procedures were successfully performed with no such evident complications as intraoperative and postoperative bleeding, embolization, mediastinal infection or death with an average hospitalization time of 15. 3±4. 09 days. Mild and moderate thoracalgia occurred in 13 patients(56. 5%), low-grade fever in 2 patients(8. 7%, recovered after symptomatic treatment for 1-2 days) . During the follow-up of 2 weeks, the rate of varices disappearance was 56. 5% (13/23) and no recurrent bleeding was observed. Six months after discharge, 10 patients underwent endoscopy again, varices disappeared in 4 and 6 with remains;the 13 others showed no hemorrhage according to follow-up call. Conclusion The therapy of endoscopic tissue adhesive injection with sequential endoscopic variceal ligation for gastroesophageal varices of Le,g type is safe and efficient.
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Acute gastric variceal bleeding is one of the most serious complications in portal hypertension, and is associated with high mortality and morbidity. Endoscopic variceal obturation (EVO) using Histoacryl(R) (n-butyl-2-cyanoacrylate) has been accepted as an effective hemostatic procedure in acute gastric variceal bleeding. However, EVO is not a widely performed because of technical difficulties and complications such as mucosal ulceration, perforation, and systemic embolism. Herein, we report a patient who developed hepatic failure caused by portal vein occlusion by Histoacryl(R) injection for management of gastric variceal bleeding.
Subject(s)
Humans , Embolism , Esophageal and Gastric Varices , Hypertension, Portal , Liver Failure , Mortality , Portal Vein , Splenic Vein , UlcerABSTRACT
PURPOSE: The object of this study is to compare the patient satisfaction in the view of scarring, cost, and hospital stay between the conventional suture method and a method using Histoacryl(R) (2-N-butylcyanoacrylate) adhesive for treating facial lacerations in the emergency department. METHODS: This study is a randomized prospective trial, which was conducted from December 2009 to January 2010. The participants include 109 patients who visited the emergency room in Deajon Eulji Medical Center. The ages ranged from 1 to 59 (mean age of 18.7), and all had facial lacerations of less than 3 cm. In order to treat the facial lacerations, an emergency medicine doctor used tissue adhesive (2-N-butylcyanoacrylate, Histoacryl(R)) for 41 patients in the experimental group, and a plastic surgeon performed conventional suturing for 68 patients in the control group. The ER-stay and the primary treatment fee were compared in the two groups, and the scarring was evaluated 10 to 11 months from suturing by using the Modified Hollander Method and the 10-cm scaled VAS (visual analogue scale: score 0=no scar, score 10=very severe scar). RESULTS: The ER stay was 76 minutes for the experimental group and 107 minutes for the control group, showing that statistically significantly less time of 31 minutes was taken in the experimental group. The cost of the experimental group was 40000 won (50.1%) more expensive than the control group, with an average cost of 121900 won for the experimental group and 81200 won for the control group. As for scar evaluation, 10.56 months after suturing, the experimental group showed a better result with a score of 2.6 compared to a score of 3.4 in the control group; however, this difference was not statistically significant (p<0.05). As to a detailed evaluation of scar characteristics, the experimental group had a statistically significantly better result in scar elevation, with a score of 0.6 compared to a score of 1.65 for the control group. CONCLUSION: If appropriate patients are selected, the method using tissue adhesive directly applied by an EM doctor not only decreases ER stay but also creates similar patients satisfaction, with statistically better result in scar elevation, compared to the conventional suture method; thus, ultimately general patient satisfaction is increased.
Subject(s)
Humans , Adhesives , Cicatrix , Emergencies , Emergency Medicine , Fees and Charges , Lacerations , Length of Stay , Netherlands , Patient Satisfaction , Prospective Studies , Sutures , Tissue AdhesivesABSTRACT
PURPOSE: The object of this study is to compare the patient satisfaction in the view of scarring, cost, and hospital stay between the conventional suture method and a method using Histoacryl(R) (2-N-butylcyanoacrylate) adhesive for treating facial lacerations in the emergency department. METHODS: This study is a randomized prospective trial, which was conducted from December 2009 to January 2010. The participants include 109 patients who visited the emergency room in Deajon Eulji Medical Center. The ages ranged from 1 to 59 (mean age of 18.7), and all had facial lacerations of less than 3 cm. In order to treat the facial lacerations, an emergency medicine doctor used tissue adhesive (2-N-butylcyanoacrylate, Histoacryl(R)) for 41 patients in the experimental group, and a plastic surgeon performed conventional suturing for 68 patients in the control group. The ER-stay and the primary treatment fee were compared in the two groups, and the scarring was evaluated 10 to 11 months from suturing by using the Modified Hollander Method and the 10-cm scaled VAS (visual analogue scale: score 0=no scar, score 10=very severe scar). RESULTS: The ER stay was 76 minutes for the experimental group and 107 minutes for the control group, showing that statistically significantly less time of 31 minutes was taken in the experimental group. The cost of the experimental group was 40000 won (50.1%) more expensive than the control group, with an average cost of 121900 won for the experimental group and 81200 won for the control group. As for scar evaluation, 10.56 months after suturing, the experimental group showed a better result with a score of 2.6 compared to a score of 3.4 in the control group; however, this difference was not statistically significant (p<0.05). As to a detailed evaluation of scar characteristics, the experimental group had a statistically significantly better result in scar elevation, with a score of 0.6 compared to a score of 1.65 for the control group. CONCLUSION: If appropriate patients are selected, the method using tissue adhesive directly applied by an EM doctor not only decreases ER stay but also creates similar patients satisfaction, with statistically better result in scar elevation, compared to the conventional suture method; thus, ultimately general patient satisfaction is increased.
Subject(s)
Humans , Adhesives , Cicatrix , Emergencies , Emergency Medicine , Fees and Charges , Lacerations , Length of Stay , Netherlands , Patient Satisfaction , Prospective Studies , Sutures , Tissue AdhesivesABSTRACT
PURPOSE: In treatment of facial bone fracture, occurred in children, we generally use wires, miniplate, absorbable plate or their combination. These foreign bodies can be palpable, and sometimes may cause infections, and need reoperation for removing. When bone fragments are multiple, small or thin, they are hard to handle and make accurate reduction of all fragments. In these cases, a biodegradable tissue adhesive, Histoacryl(R) (n-butyl-2-cyanoacrylate), can be used as fixation technique for small, multiple, and thin fracture fragments. METHODS: 3 years old and 6 years old children, who has comminuted fracture on frontal sinus, we used Histoacryl(R) for fixation of multiple bone fragments. After approaching by coronal incision, we pulled out all bone fragments and reconstructed bone fragments by Histoacryl(R) and fixed those on frontal sinus by absorbable plates. RESULTS: Photographs and 3-dimensional CT obtained preoperatively and postoperatively. And we compared them each other in terms of accuracy of reconstructed bony contour. We could reconstruct almost all bone fragments easily along 3-dimensional structure and get excellent aesthetic results. There was no complication such as infection. CONCLUSION: In treatment of comminuted facial bone fracture, occurred in children, Histoacryl(R) is an excellent method for accurate reconstruction in small and thin bone fragments which cannot be fixed by wire, miniplate or absorbable plate without complication.
Subject(s)
Child , Humans , Enbucrilate , Facial Bones , Foreign Bodies , Fractures, Comminuted , Frontal Sinus , Reoperation , Tissue AdhesivesABSTRACT
PURPOSE: The standard treatments of hand fractures today are fixations by K -wires, metal plates, wires and lag screws. But it is very difficult to reconstruct fractures by placing implants into small bony fragments especially in the comminuted fractures and intra-articular fractures. This paper describes a simple method of reconstruction with Histoacryl(R) for comminuted and intra-articular fractures in hands. METHODS: 2 cases with comminuted and intra-articular fractures by crushing injury were reconstructed with Histoacryl(R). We performed applying Histoacryl(R) with swab on the bone cortex carefully to avoid Histoacryl(R) infiltrating into the medulla. We could rearrange and fixate bony fragments using only Histoacryl(R), in addition, metal plates, K-wires, wires, and lag screws could be used for secondary fixation if needed. RESULTS: Post-operative X-ray finding of 2 patients assured that the bony fragments of the hand fractures maintained their original positions. Significant displacement and deviation, infection, nonunion, and malunion during the follow-up period were not observed. CONCLUSION: This study showed the possibility of using Histoacryl(R) in addition as a simple method of fixation in the comminuted and intra-articular hand fractures.
Subject(s)
Humans , Displacement, Psychological , Enbucrilate , Follow-Up Studies , Fractures, Comminuted , Hand , Intra-Articular FracturesABSTRACT
We report two cases of adrenal abscesses that occurred following a Histoacryl(R) (N-butyl-2-cyanocrylate) injection for variceal bleeding. Patients had been diagnosed with alcoholic liver cirrhosis and gastric varices bleeding and received a Histoacryl(R) injection for the variceal bleeding. Patients had fever and abdominal tenderness and were diagnosed with an adrenal abscess at 2 months following the Histoacryl(R) injection. One patient received open drainage and the other underwent percutaneous drainage. When a patient has previously been injected with Histoacryl(R) for the treatment of variceal bleeding and presents with fever, an evaluation for an unusual complication such as adrenal abscess is recommended.
Subject(s)
Humans , Abscess , Drainage , Enbucrilate , Esophageal and Gastric Varices , Fever , Hemorrhage , Liver Cirrhosis, AlcoholicABSTRACT
PURPOSE: Comparing with suture and staple, skin graft fixation with Histoacryl (N-butyl-cyanoacrylate, B.Braun, Germany) has two advantages. Fixation is simple, painless and removal process is unnecessary. There are few reports that compare histoacryl with conventional methods for skin graft fixation in FTSG. However, there are no comparative studies in STSG. The purpose of this study is to show our experience of skin graft fixation with histoacryl in STSG of burn patients. METHODS: This study included those who was burned less than 10% of TBSA and needed STSG. The patients who had underlying disease (DM, hypertension, liver disease, lung disease) were excluded. 29 patients who visited Bestian burn center from January to July 2009 was enrolled in the study. In STSG, skin graft was fixed with histoacryl and authors marked the fixed points with pen. Fixation rate was checked in 7 days after STSG and take rate was checked in 14 days after STSG. RESULTS: The patient group consisted of 7 males and 22 females. The mean extent of burn area was 2.3%. The type of injury consisted of 18 contact, 8 scald, 1 flame, 2 friction. 31 STSG of 29 patients was done. STSG was done at 24th day after burn, the mean area of wound for STSG was 51 cm2. Mean numbers of fixation point with histoacryl per patients were 14.1. 430 of 436 fixation were stable and fixation rate was 98.6%. There was no infection case. Take rate was 99.1% in 14 days after STSG and it took 21 days for wound opening. CONCLUSION: Until now, suture and staple are common methods in skin graft fixation. However, it is disadvantageous that suture and staples should be removed. Histoacryl does not need those process. This study showed that take rate was 99.1% and fixation rate was 98.6% in fixation with histoacryl. In STSG, Skin graft fixation with histoacryl could be alternative methods for suture and staple.
Subject(s)
Female , Humans , Male , Burn Units , Burns , Enbucrilate , Friction , Hypertension , Liver Diseases , Lung , Skin , Sutures , Tissue Adhesives , TransplantsABSTRACT
Upper gastrointestinal bleeding is a primary and emergency complication of peptic ulcer. Injection of Histoacryl (N-butyl-2-cyanoacrylate) is an effective endoscopic hemostasis procedure to treat peptic ulcer bleeding. However, Histoacryl injection is not a widely used method because of its various and sometimes severe complications. Therefore, the use of Histocaryl should be considered as a second line treatment modality to achieve therapeutic endoscopic hemostasis when the conventional treatment modalities fail or the patient has a high risk of needing operative therapy. Three patients, who had gastric ulcer bleeding from an exposed blood vessel, were each treated by an injection of Histoacryl diluted with Lipiodol at a dilution ratio of 1:1. All 3 procedures were successfully accomplished without any complications.
Subject(s)
Humans , Blood Vessels , Emergencies , Enbucrilate , Ethiodized Oil , Glycosaminoglycans , Hemorrhage , Hemostasis, Endoscopic , Peptic Ulcer , Stomach UlcerABSTRACT
Bleeding from esophageal and gastric varices is a life-threatening complication for patients with liver cirrhosis. Endoscopic injection of Histoacryl(R)(N-butyl-2-cyanoacrylate) has been reported to be an effective therapy for variceal bleeding; however, distal embolization of unwanted areas has been described in some cases with a fatal outcome. A change in the rationale of treatment of variceal bleeding in patients with liver cirrhosis was not advocated because of the infrequency of such cases. We report two cases of splenic infarction with celiac trunk and pulmonary emboli as serious complications of Histoacryl(R) injection.
Subject(s)
Humans , Esophageal and Gastric Varices , Fatal Outcome , Hemorrhage , Hepatic Artery , Liver Cirrhosis , Pulmonary Embolism , Splenic InfarctionABSTRACT
BACKGROUND/AIMS: Gastric variceal bleeding is an infrequent but serious complication of portal hypertension. Endoscopic injection of Histoacryl(R) (N-butyl-2-cyanoacrylate) has been approved as an effective treatment for gastric variceal bleeding. The aim of this study was to evaluate the long-term efficacy and safety of the endoscopic injection of Histoacryl(R) for the treatment of gastric varices. METHODS: Between January 1994 and January 2005, eighty-five patients with gastric varices received endoscopic injections of Histoacryl(R) . Among these 85 patients, 65 received the procedure within 1 week after gastric variceal bleeding, and 13 received as a prophylactic procedure. According to the Sarin classification, 32 patients were GOV1 and 53 were GOV2. Most of the varices were large (F2 or F3, 75 patients). The average volume of Histoacryl(R) per each session was 1.43 ml. Among 85 patients, 72 patients were followed-up and the median duration was 24.5 months. RESULTS: The rate of initial hemostasis was 98.6% and recurrent bleeding occurred in 29.2% (21 of 72). When rebleeding occurred, 76.2% was within 1 year after the initial injection. Treatment failure-related mortality rate was 1.4% (1 of 85). Twenty-seven patients died, mostly due to hepatocelluar carcinoma or liver failure. Two patients experienced pulmonary embolism and one experienced splenic infarction. They recovered without specific treatment. Rebleeding rate had a tendency to increase in patients with hepatocelluar carcinoma (p=0.051) and GOV2 (p=0.061). CONCLUSIONS: Histoacryl(R) injection therapy is a effective treatment method for gastric varices with high initial hemostasis rate and low major complications.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Enbucrilate/administration & dosage , Endoscopy, Gastrointestinal , Esophageal and Gastric Varices/mortality , Gastrointestinal Hemorrhage/mortality , Injections , Predictive Value of Tests , Retrospective Studies , Sclerosing Solutions/administration & dosage , Severity of Illness Index , Survival RateABSTRACT
Duodenal varix is a rare cause of hemorrhage in patients with portal hypertension, however their rupture is serious and often life threatening. Treatments for duodenal variceal bleeding include endoscopic procedures, surgery, or interventional radiologic procedures. We report a case of duodenal varices rupture in a 45-year-old man with alcoholic liver cirrhosis who presented with melena and dizziness. Emergent upper endoscopy revealed large nodular varices with a ruptured erosion on the top in the distal second portion of duodenum. Two consecutive injections with 1.0 mL of n-butyl-2-cyanoacrylate (Histoacryl; Braun-Melsungen, Germany) mixed with 1.0 mL of lipiodol (Laboratoire-Guerbet, France) were performed intravariceally and achieved successful hemostasis. This suggests that endoscopic injection sclerotherapy with histoacryl may be an effective therapeutic option for the control of ruptured duodenal variceal bleeding.
Subject(s)
Humans , Male , Middle Aged , Duodenal Diseases/etiology , Duodenoscopy , Duodenum/blood supply , Enbucrilate/analogs & derivatives , Gastrointestinal Hemorrhage/etiology , Liver Cirrhosis, Alcoholic/complications , Rupture , Sclerosing Solutions/therapeutic use , Sclerotherapy , Tissue Adhesives/therapeutic use , Tomography, X-Ray Computed , Varicose Veins/complicationsABSTRACT
Broncho-esophageal fistula is a disease of varying etiologies. Spontaneous fistula occurs as a result of malignancy, radiotherapy or inflammatory disease. The majority of fistulas are caused by iatrogenic causes. Treatment of fistula usually consists of surgery and conservative management. Recently, it has been reported that broncho-esophageal fistula can be treated endoscopically using tissue adhesive agent such as Histoacryl(R) and fibrin glue. We report a case of broncho-esophageal fistula as a complication of tuberculosis that was successfully treated by radiological Histoacryl(R) injection therapy with a review of literatures.
Subject(s)
Fibrin Tissue Adhesive , Fistula , Radiotherapy , Tissue Adhesives , TuberculosisABSTRACT
BACKGROUND/AIMS: Histoacryl forms hard substances in an instance after a brief exposure to polar liquid, blood or body temperature. This often causes obstruction of injector and endoscopic channel. Furthermore, splashed Histoacryl during injection can lead to accidental loss of vision. We propose a new convenient method of Histoacryl-lipiodol sequential injection and report the results. METHODS: From May 2001 to August 2004, sequential injector method was performed in treating consecutive thirty gastric varices patients. Histoacryl (S.G. 1.0) 1 mL and lipiodol (S.G. 1.28) 1~1.5 mL are filled in 2.5 mL disposable syringe with 16 gauge needle, which are separated into two compartments by specific gravity difference. The injector attached side of charged syringe is gently placed upward and the piston is pushed after the lesion site puncture. Then, normal saline is promptly infused to wash out and the needle is withdrawn. RESULTS: There were 26 males and 4 females. 4 had active bleeding and 26 had the stigmata of bleeding. Varices types were Lg-c in 10, Lg-cf in 16 and Lg-f in 4 patients and the Child-Pugh classification were A in 17%, B in 53% and C in 30%. The average amount was 1.53 mL. Initial hemostasis rate was 97%, 3 of patients re-bled in 4 weeks and 2 patients later. One patient died after the procedure and a case of procedure related bacteremia has occurred. CONCLUSIONS: Histoacryl-lipiodol sequential injection by specific gravity difference is convenient and safe. Also, it carries less damage to the instruments.
Subject(s)
Female , Humans , Male , Bacteremia , Body Temperature , Christianity , Classification , Enbucrilate , Esophageal and Gastric Varices , Ethiodized Oil , Hemorrhage , Hemostasis , Needles , Punctures , Specific Gravity , Syringes , Varicose VeinsABSTRACT
Tissue adhesives have gained popularity for quicker and painless closure of lacerations. The use of tissue glue is currently popular for the closure of superficial lacerations, especially in children. Histoacryl Blue(R)(2-N-butylcyanoacrylate) is a topical wound closure that precludes the need for foreign bodies to close wounds. The purpose of this study was to compare the applications of Histoacryl Blue(R)(HAB) and conventional suture, regarding cosmetic outcome. To compare the short term and long term results of various repair methods, we designed the prospective, randomized, blind study. Patients with laceration undergoing repair were randomly allocated to conventional suture, subcutaneous suture plus HAB, and HAB only groups. The exclusion criterions were large wound that require large tension for repair or avulsion wound. An independent, blinded observer assessed cosmetic result at 7-10 days after repair and 3-9 months postoperatively. Physician's satisfaction with wound appearance was recorded on 100 mm Visual Analogue Scale(VAS)(0=worst, 100=best). The difference in VAS score between conventional suture method and subcutaneous suture plus HAB methods were not significant. Tissue glue being easy to use with no complications and still resulting in equivalent cosmetic outcomes has several benefits. Especially in the case of children, the wound closure with Histoacryl Blue(R) could be a good alternative for repair of laceration in emergency room.