Coil-assisted N-butyl cyanoacrylate embolization vs covered stent implantation for delayed hemorrhage in hepatobiliary and pancreatic surgery

Table 1 Patient baseline characteristics between N-butyl cyanoacrylate and covered stent implantation groups, n (%)

Variable	NBCA group (n = 45)	CSI group (n = 60)	P value
Sex			0.494
Male	32 (71.1)	47 (78.3)
Female	13 (28.9)	13 (21.7)
Age (years)			0.559
< 60	22 (48.9)	33 (55.0)
≥ 60	23 (51.1)	27 (45.0)
Indication for surgery			0.005
Biliary tract cancer	26 (57.8)	25 (41.7)
Carcinoma of ampulla	7 (15.6)	6 (10.0)
Pancreatic cancer	4 (8.9)	9 (15.0)
Hepatocellular carcinoma	4 (8.9)	0 (0.0)
Benign	4 (8.9)	20 (33.3)
Time of onset (days)1	11.3 ± 8.2	15.7 ± 8.8	0.010
Clinical manifestations			0.069
Gastrointestinal bleeding	23 (51.1)	19 (31.7)
Hemorrhage from intra-abdominal	22 (48.9)	41 (68.3)
Risk factors for hemorrhage
Pancreatic fistula	24 (53.3)	25 (42.4)	0.323
Biliary fistula	6 (13.3)	3 (5.0)	0.167
Abdominal infection	31 (68.9)	23 (38.3)	0.003
Coagulopathy2	24 (53.3)	17 (28.8)	0.015
HB before endovascular treatment (g/L)1	65.4 ± 19.8	78.7 ± 16.3	0.000
Hemodynamic instability3	39 (86.7)	41 (68.3)	0.037

¹Data include the mean ± SD (range).

²Prothrombin time > 15 seconds, international normalized ratio > 1.5, or platelet count < 80000/mm³.

³Hemodynamic instability was defined as hypotension with systolic pressure < 90 mmHg and heart rate > 100 beats/minute or clinical shock secondary to blood loss that had not responded to conservative medical treatment including blood transfusion.

CSI: Covered stent implantation; HB: Hemoglobin; NBCA: N-butyl cyanoacrylate.

Table 2 Procedure-related details and clinical outcomes, n (%)

Variable	NBCA group (n = 45)	CSI group (n = 60)	P value
Arteriographic findings			0.351
Extravasation of contrast media	37 (82.2)	44 (73.3)
Pseudoaneurysm	8 (17.8)	16 (26.7)
Parent artery			0.000
Splenic artery	13 (28.9)	6 (10.0)
Common hepatic artery	14 (31.1)	46 (76.7)
Right hepatic artery	7 (15.6)	6 (10.0)
Left hepatic artery	2 (4.4)	0 (0.0)
Left gastric artery	6 (13.3)	1 (1.7)
Branch of superior mesenteric artery	3 (6.7)	1 (1.7)
Technical success	45 (100)	53 (88.3)	0.019
Clinical success	42 (93.3)	44 (73.3)	0.010
Clinical failure and follow-up treatment	3 (6.7)	16 (27.6)
Continuous hemorrhage and death	2	5
Surgical operation	1	4
CSI	0	4
Coil-assisted NBCA embolization	0	3
30-day mortality	8 (17.8)	11 (18.3)	1.000
Severe intervention-related AEs	0 (0)	1 (1.7)	1.000

AE: Adverse event; CSI: Covered stent implantation; NBCA: N-butyl cyanoacrylate.