Feasibility of gel-like radiopaque embolic material using gelatin sponge and contrast agent for tract embolization after percutaneous treatment

Abstract

Objectives Tract embolization has been performed to prevent bleeding after trans-organ puncture. This study evaluated clinical outcomes of tract embolization using a gel-like radiopaque material comprising two sheets of gelatin sponge and 3 mL of contrast agent, and experimentally confirmed its viscosity and hemostatic efficacy. Methods Three study phases were planned. In a clinical setting, 57 consecutive patients who underwent tract embolization after transhepatic puncture were retrospectively analyzed. Clinical success was evaluated as absence of bleeding complications for 30 days after the procedure. In a basic experiment, viscosity of the material was analyzed. In an animal experiment, rabbit kidney puncture site was embolized via a 7-Fr sheath using this material, coils, or N-butyl-2-cyanoacrylate glue or received no embolization while removing the sheath. Amounts of tract bleeding were measured for 1 min and compared between groups. Results Embolization was successfully completed in all clinical cases. No postoperative bleeding requiring intervention was encountered. The basic experiment revealed the material was highly viscous. In the animal experiment, mean weights of bleeding in the control, gel-like embolic material, coil, and N-butyl-2-cyanoacrylate glue groups were 1.04±0.32 g, 0.080±0.056 g, 0.20±0.17 g and 0.11±0.10 g, respectively. No significant differences were seen among embolization groups, while the control group showed significantly more bleeding than any embolization group. Conclusion Tract embolization with this gel-like radiopaque embolic material appears safe and feasible. Advances in knowledge Tract embolization using this embolic material with two sheets of gelatin sponge and 3 mL of contrast agent offers a safe, feasible, and economical procedure after trans-organ puncture, because the material offers the following characteristics: visibility under X-ray; viscosity facilitating retention in the tract; ability to allow repeated puncture via the same route; and low cost.