Transcatheter Vascular Occlusion Therapy with Isobutyl 2-Cyanoacrylate (Bucrylate) for Control of Massive Upper-Gastrointestinal Bleeding

Transcatheter embolization with bucrylate, a tissue adhesive, was performed in 16 patients with massive upper-gastrointestinal bleeding. Control of arterial bleeding from the stomach was achieved in 6 of 8 patients, and from the duodenum in 3 of 4. Embolization of gastric veins resulted in temporary control of esophageal variceal bleeding in 3 of 4 patients. Histological study showed no evidence of bucrylate causing histotoxicity in 2 patients. Because bucrylate polymerizes rapidly, a localized vascular occlusion mimicking a surgical ligation is produced. Because collateral vessels are not occluded, localized tissue ischemia is unlikely. Tissue adhesives are, however, difficult to use.