Safety and efficacy of Glubran-2® endovascular embolization in acute bleeding patients with coagulopathies: a multicenter experience.

PURPOSE: This study aims to analyze safety and effectiveness of glue (Glubran-2) embolization in acute bleeding patients with coagulopathies; data were analyzed according to two bleeding risk categories based on coagulation status.

MATERIALS AND

METHODS

This retrospective study included patients treated with glue endovascular embolization for acute bleedings in high-volume centers experienced with liquid embolics. Coagulopathy was defined as almost one of the following elements: international normalized ratio (INR) > 1.5; platelet count < 80.000/mm3; and anticoagulant and/or antiplatelet therapies at the time of embolization. If multiple conditions overlapped, patients were classified as high-risk category; otherwise, they were considered as standard risk.

RESULTS

Sixty-seven subjects were considered for this analysis. The underlying causes of bleeding were traumatic in 67.2% and spontaneous in 32.8%. At hospital admission, most patients were hemodynamically stable (86.6%). All patients took anticoagulant or antiplatelet therapies at the time of the intervention; 11.9% presented with INR > 1.5 and 14.9% had platelet counts < 80.000/mm3; 58.2% were classified as standard risk and 41.8% as high risk. Technical success was achieved in all cases while clinical success was obtained in 85%. In-hospital mortality was 6.0%. Procedure-related complications occurred in 4.5%. Comparing patients at high risk with those at standard risk, technical and clinical success rates were similar.

CONCLUSIONS

In this study Glubran-2 appeared to be an effective embolic glue in bleeding patients with coagulopathy, even in those subjects with multiple coagulopathic conditions increasing the risk of bleeding; future studies, including more patients and less trained operators, are required to confirm these outcomes.