Second-Generation Hydrogel Coils for Transcatheter Arterial Embolization of Acute Arterial Bleeding in the Body Trunk

Abstract

Introduction

First-generation hydrogel coils have been shown to reduce the risk of recanalization due to their expansion properties. However, their clinical use has been limited by coil stiffness and time constraints for deployment. Recently developed second-generation hydrogel coils are softer and offer improved deliverability. This study aimed to evaluate their feasibility and effectiveness in transcatheter arterial embolization (TAE) for acute arterial bleeding in the body trunk.

Methods

This retrospective study included 24 TAE procedures performed in 23 patients (15 men, 8 women; median age, 72 years; range, 14-88 years) between March 2019 and November 2024. Indications for TAE included iatrogenic injury (n = 7), gastrointestinal bleeding (n = 5), trauma (n = 3), aneurysm rupture (n = 3), tumor invasion (n = 3), and others (n = 3). Second-generation hydrogel coils were used in all cases, comprising a median of 78% (range, 13-100%) of the total coil length. Technical success was defined as complete occlusion of the target artery on digital subtraction angiography. Clinical success was defined as the absence of rebleeding within 24 h of embolization.

Results

Anemia, hemorrhagic shock, and coagulopathy were present before TAE in 92% (22/24), 21% (5/24), and 25% (6/24) of procedures, respectively. The mean total coil length was 40 cm (range, 4-127 cm), and the mean procedure time was 111 min (range, 58-207 min). Both technical and clinical success rates were 100% (24/24). One complication (4%) occurred: transient liver dysfunction in a patient treated for hepatic artery bleeding.

Conclusions

TAE using second-generation hydrogel coils showed high technical and clinical success rates, indicating that these coils may be a feasible and effective option for managing acute arterial hemorrhage in the body trunk.