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Imipenem/cilastatin sodium (IPM/CS) as an embolic agent for transcatheter arterial embolisation: a preliminary clinical study of gastrointestinal bleeding from neoplasms

Reiko Woodhams1*, Hiroshi Nishimaki2, Go Ogasawara1, Kaoru Fujii1, Takuro Yamane1, Kenichiro Ishida1, Fumie Kashimi3, Keiji Matsunaga1 and Masakazu Takigawa4

Author Affiliations

1 Department of Diagnostic Radiology, Kitasato University School of Medicine, 1-15-1, Kitasato, Sagamihara, Minami-ku, Kanagawa 252-0374, Japan

2 Department of Cardiovascular Surgery, St. Marianna University School of Medicine, 2-16-1, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan

3 Department of Critical care and Emergency Medicine, Kitasato University School of Medicine, 1-15-1, Kitasato, Sagamihara, Minami-ku, Kanagawa 252-0374, Japan

4 Department of Radiology, National Hospital Organization, Sagamihara National Hospital, 18-1, Sakuradai, Minami-ku, Sagamihara, Kanawaga 252-0392 Japan

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SpringerPlus 2013, 2:344  doi:10.1186/2193-1801-2-344

Published: 26 July 2013

Abstract

Purpose

To evaluate the feasibility and usefulness of imipenem/cilastatin sodium (IPM/CS) as an embolic agent for intestinal bleeding from neoplasms.

Materials and methods

Seven patients who underwent 11 transarterial embolisations (TAEs) using IPM/CS as an embolic material for duodenal or small/large intestinal tumour bleeding from January 2004 to December 2011 were retrospectively evaluated. A mixture of IPM/CS and contrast medium was introduced through the microcatheter positioned at the feeding artery to the tumour until extravasation disappeared or stasis of blood flow to the tumour staining was observed.

Results

Haemostasis was obtained in all patients. Therefore, the technical success rate was 100%. Rebleeding was observed in four patients. All of them underwent repeat TAE using IPM/CS, and haemostasis was obtained successfully. No complication was identified following laboratory and clinical examinations. No haemorrhagic death occurred. Haemorrhagic parameters, including blood haemoglobin and the amount of blood transfusion, improved after TAE.

Conclusion

The safety, feasibility, and effectiveness of TAE using IPM/CS as an embolic material for intestinal bleeding from neoplasms were suggested by this study. The mild embolic effect of IPM/CS may be adequate for oozing from tumours. Although rebleeding may occur after embolotherapy using IPM/CS, repeat embolisation is effective as treatment for rebleeding.

Keywords:
Bleeding; Neoplasm; Embolisation; IPM/CS