Particulate polyvinyl alcohol

Absolute alcohol and particulate polyvinyl alcohol (PVA) emboli have no role in the trauma patient. 

Particulate embolization is an option when contrast extravasates and the bleeding branch is beyond the reach of superselective catheterization (Fig. 5.7). Non-calibrated polyvinyl alcohol particles (PVA) in sizes of 150-250 [i to 250-350 p or even larger should be used. The amount of particles should be kept as low as possible to avoid diffuse distal embolization. After each injection of 0.1-0.2 ml (up to a maximum of 1 ml) of a dilution of PVA, control arteriography should verify that the bleeding point has been... 

Flush thoracic aortography and selective celiac and left gastric angiography should be performed. If an actively bleeding vessel is identified, it maybe possible to stop the hemorrhage by selective catheterization of the bleeding vessel followed by embolization with coils, Gelfoam, or particulate matter (e.g., polyvinyl alcohol) (Kos et al. 1998). 

Polyvinyl alcohol (PVA) is a semipermanent flow-directed injectable particulate agent that can also be useful for treating iatrogenic hemorrhage. 

The size and extent of the tumor, the need to preserve any of the renal parenchyma, and the overall goal of embolization should be considered in planning embolotherapy of renal tumors. Historically, the choice of embolic agents depended on the experience and preference of the operator. Although more than twenty embolic agents have been used (Table 16.2), it is most worthwhile to consider three classes of embolic agents currently used for embolizations of renal tumors liquid agents (the prototype of which is absolute ethanol), particulate materials (the prototype of which is polyvinyl alcohol foam), and metallic coils. 

Nordback, J, Lundberg, E and Christie, WW (1998) Separation of lipid classes from marine particulate material by HPLC on a polyvinyl alcohol-bonded stationary phase nsing dualchannel evaporative light-scattering detection. Marine Chem., 60,165-175. 

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