Efficacy, safety and outcomes of transcatheter arterial embolization with N-butyl cyanoacrylate glue for non-variceal gastrointestinal bleeding: A systematic review and meta-analysis - 26/06/21

Doi : 10.1016/j.diii.2021.03.004

Olivier Chevallier ^a, Pierre-Olivier Comby ^a, Kevin Guillen ^a, Julie Pellegrinelli ^a, Thomas Mouillot ^b, Nicolas Falvo ^a, Marc Bardou ^b, Marco Midulla ^a, Serge Aho-Glélé ^c, Romaric Loffroy ^a,⁎
^a Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, ImViA Laboratory-EA 7535, François-Mitterrand University Hospital, 21079 Dijon, France
^b Department of Gastroenterology and Hepatology, François-Mitterrand University Hospital, 21079 Dijon, France
^c Department of Epidemiology and Biostatistics, François-Mitterrand University Hospital, 21079 Dijon, France

^⁎Corresponding author.

connectez-vous ou créez un compte

Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.

Connectez-vous pour en bénéficier!

Highlights

•	Transcatheter arterial embolisation (TAE) with N-butyl cyanoacrylate (NBCA) for managing non-variceal gastrointestinal bleeding (GIB) is effective, with a high clinical success rate.
•	TAE with NBCA for managing non-variceal GIB is safe, with a low major complication rate.
•	The use of NBCA for TAE of non-variceal GIB does not seem to cause more significant ischemic complications than other embolic agents.

Le texte complet de cet article est disponible en PDF.

Abstract

Purpose

To perform a systematic review and meta-analysis to determine the safety, efficacy, and outcomes of transcatheter arterial embolization (TAE) with N-butyl cyanoacrylate (NBCA) as the single embolic agent for the management of non-variceal upper and lower gastrointestinal bleeding (GIB).

Materials and methods

A literature search using MEDLINE/PubMed, EMBASE, and SCOPUS databases was performed for studies published from January 1980 to December 2019. Data from eligible studies were extracted and evaluated by two independent reviewers. Exclusion criteria were sample size <5, article reporting the use of NBCA with other embolic agents, no extractable data, and duplicate reports. Technical success, clinical success, 30-day rebleeding, 30-day overall and major complications, and 30-day mortality were evaluated. The estimated overall rates were calculated with their 95% confidence intervals, based on each study rate, weighted by the number of patients involved in each study. Heterogeneity across studies was assessed using the Q test and I² statistic.

Results

Fifteen studies with 574 patients were included. For upper GIB (331 patients), the technical and clinical success rates, and 30-day rebleeding and mortality rates, were 98.8% (328 of 331 patients) and 88.0% (237 of 300 patients), and 12.5% (69 of 314 patients) and 15.9% (68 of 331 patients), respectively. Thirty-day overall and major complications occurred in 14.3% (28 of 331 patients) and 2.7% (7 of 331 patients) of patients, respectively. For lower GIB (243 patients), the technical and clinical success rates, and 30-day rebleeding and mortality rates, were 98.8% (78 of 78 patients) and 78.0% (145 of 189 patients), and 15.7% (33 of 218 patients) and 12.7% (14 of 78 patients), respectively. Thirty-day overall and major complications occurred in 13.0% (25 of 228 patients) and 8.6% (19 of 228 patients) of patients, respectively.