Transcatheter Arterial Embolization with N-butyl-2 Cyanoacrylate or not for Iatrogenic Renal Hemorrhage under Normal Coagulation Condition.

Objective: To evaluate the effectiveness and safety of transcatheter arterial embolization (TAE) with N-butyl-2 Cyanoacrylate (NBCA) versus without NBCA for the treatment of iatrogenic renal hemorrhage (IRH) in patients with normal coagulation profiles.

Methods: Forty-nine participants with normal coagulation profiles were divided into two groups: NBCA (n = 12) and non-NBCA (n = 37). The primary outcome assessed was the primary clinical success rate, with secondary analyses conducted on technical success rate, secondary clinical success rate, procedure duration and cost, angiographic results, and adverse events.

Results: Patients exhibited a near-normal coagulation condition (98.4%, 50/51). Technical success was attained in all patients, with no statistically significant differences observed between primary clinical success rate (p > 0.99), secondary clinical success rate (p > 0.99), procedure time (p = 0.469), and surgical costs (p = 0.057) when comparing the sides. In the non-NBCA group, negative angiographic findings were more prevalent compared to the NBCA group (43.2% vs 0, p = 0.012). No significant differences were found in serum creatinine and urea levels before and after treatment in both groups (p > 0.05). Minor complications were observed after the TAE procedure, with a higher percentage in the NBCA group compared to the non-NBCA group (p = 0.088).

Conclusions: TAE has been shown to be a safe and effective treatment for IRH in patients with normal coagulation conditions, regardless of the use of N-butyl cyanoacrylate (NBCA) glue.

Advances in knowledge: There were no significant differences in procedure time or costs between the NBCA group and other treatment modalities. However, these findings require validation in large-scale randomized controlled trials.