Gelfoam embolization

Coils are available in a wide variety of sizes from 2 mm to 15 mm in size and are made from either stainless steel or platinum and may have Dacron fibers placed at right angles to the long axis of the coil to increase the surface area and thereby to increase the speed and permanence of thrombosis. In practice, most coils utilized in microcatheters are platinum and those in 4- to 5-F catheters, stainless steel. It should be noted that all coils are permanent devices and should be utilized when the desired occlusion is permanent. Coils should not be used in combination with particulate embolization for the treatment of tumors, as they will occlude the access for further treatment. Coils may, on the other hand, be utilized with Gelfoam embolization in the treatment of pelvic bleedings allowing the hemorrhage to be halted quickly and permanently. 

Gold RE, Grace DM (1975) Gelfoam embolization of the left gastric artery for bleeding ulcer experimental considerations. Radiology 116 575-580... 

Jander HP, Russinovich NAE (1980) Transcatheter Gelfoam embolization in abdominal, retroperitoneal, and pelvic hemorrhage. Radiology 136 337-344... 

For this reason, when an embolotherapy is planned we recommend immediate cessation of prostaglandin Ej agonist infusion. In case of arterial spasm at the ostium of the uterine artery, the use of a coaxial system with a microcatheter is then required. It is possible to successfully catheterize the distal part of the uterine artery in most cases. In these circumstances, the preferred embolic agent is the one that can be easily delivered through a microcatheter, such as PVA (Polyvinyl alcohol) or Embospheres. We prefer to use particles with larger diameters, such as Embospheres 700-900 mg. Even if these particles are used for the above-mentioned reasons, additional Gelfoam embolization of internal iliac arteries is performed because of the extensive collateral pathways of the female pelvis. 

Bass EM, Crosier JH (1977) Percutaneous control of post-traumatic hepatic hemorrhage by gelfoam embolization. J Trauma 17 61-63... 

Uchida H, Ohishi H, Matsuo N (1990) Transcatheter hepatic segmental arterial embolization using Lipiodol mixed with an anticancer drug and Gelfoam particles for hepatocellular carcinoma. Cardiovasc Intervent Radiol 13 140... 

Transarterial embolization (TAE) By occluding the smaller tumour-feeding arteries, it is possible to achieve a hypoxia-induced necrosis of the HCC. This is more successful if the tumour is encapsulated. Such embolization can be carried out using collagen particles, polyvinyl alcohol, gelfoam or galactose spheres. However,... 

TAE is achieved by using co-axial micro-catheters in order to be able to achieve selective embolization. Most radiologists will use either coils (permanent) or gelfoam (temporary) to embolize vessels. The... 

Choice of embolic material/method is paramount and must be based on the target vascular territory and the desired effect. Ability to reach distal vascular beds. For example, emergent non-selective embolization of a large vascular territory is best accomplished with a potentially temporary occlusive agent such as Gelfoam. 

Barth KH, Strandberg JD, White RI (1977) Long-term follow-up of transcatheter embolization with autologous clot, oxycel, and gelfoam in domestic swine. Invest Radiol 12 273-280... 

Carmignani G, Belgrano E, Martorana G, Puppo P (1978) Clots, oxycel, gelfoam, barium, and cyanoacrylates in transcatheter embolization of rat kidney. Invest Urol 16 9-12... 

If contrast medium extravasation is demonstrated, the location on the arterial tree determines the technique of embolization (Table 5.2). If blood spurts from a main artery such as the gastroduodenal, then embolic hemostasis should be performed at the site of rupture to be effective and safe. If the bleeding point cannot be reached, embolization by injection of Gelfoam from a distance might be safe yet uncertain as the bleeding might stop only temporarily. 

If structural abnormalities such as vascular malformations, hypervascular tumors, vessel wall irregularities suggesting erosion etc., are visualized, then we may try for a palliative embolization with Gelfoam or particulates. Rarely, curative embolization of an arteriovenous malformation or fistula is achievable with non-resorbable agents, such as glue or detachable balloons. 

Bleeding from hypervascular tumors, such as duodenal metastasis of renal cell carcinoma, can be stopped by palliative particulate embolization (Fig. 5.8), although other authors preferred Gelfoam [88,89). 

The preferred embolic agent is a material that is resorbable. The one most widely used is Gelfoam. Gelfoam can be cut into different sizes depending on the target vessel diameter. The Gelfoam can also be cut in torpedo and inserted into a 1-ml syringe. 

In the absence of arterial spasm, embolization with Gelfoam pledge of both uterine and internal iliac arteries is always performed in order to obtain a bilateral proximal and distal embolization to prevent rebleeding. Even with Gelfoam pledge, we always use large-cut sizes to prevent embolization that is too distal. Embolization with coils is not per-... 

The angiographic endpoint of uterine artery embolization with non-spherical PVA or Gelfoam is usually until there is stasis or near stasis in the artery [35,45-49]. 

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