{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T15:45:58Z","timestamp":1782402358834,"version":"3.54.5"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100020333","name":"Guerbet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020333","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Radiol."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the safety and effectiveness of transcatheter arterial embolization (TAE) using n-butyl cyanoacrylate metacryloxysulfolane (NBCA-MS) as a first-line embolic agent for the management of traumatic and iatrogenic non-visceral arterial hemorrhages in an emergency setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This retrospective study included all consecutive patients who underwent selective TAE with NBCA-MS for non-visceral hemorrhage of traumatic or iatrogenic origin between June 2021 and June 2025. All patients were assessed with contrast-enhanced multidetector computed tomography (CT) demonstrating active arterial bleeding or pseudoaneurysm prior to embolization. TAE was performed via a femoral approach using selective microcatheterization, followed by embolization with NBCA-MS mixed with ethiodized oil at variable dilutions. Technical success was defined as complete angiographic occlusion of the bleeding vessels. Clinical success was defined as sustained hemostasis without need for repeat endovascular or surgical intervention \/within 30 days. Procedure-related complications were recorded according to CIRSE guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty-four patients (37 males; median age 60.5 years) underwent 54 TAE procedures. Traumatic hemorrhage accounted for 83.3% of cases, and iatrogenic hemorrhage for 16.7%. A single artery was embolized in 72.2% of procedures. Technical success was achieved in all cases (100%). Clinical success was observed in 46 patients (85.2%). Six patients required repeat embolization due to hemorrhage from vessels within the same vascular territory that had not been bleeding during the initial procedure and were therefore not embolized at that time. No procedure-related deaths, major complications, or off-target embolizations were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>NBCA-MS-based TAE is a safe, effective, and versatile treatment for traumatic and iatrogenic non-visceral arterial hemorrhage. Its high technical success, favorable clinical outcomes, and excellent safety profile support its use as a reliable first-line embolic agent in urgent clinical scenarios.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fradi.2026.1878048","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T14:47:56Z","timestamp":1782398876000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Transcatheter arterial embolization using n-butyl cyanoacrylate metacryloxysulfolane for traumatic or iatrogenic non-visceral hemorrhage"],"prefix":"10.3389","volume":"6","author":[{"given":"Paolo Federico","family":"Garducci","sequence":"first","affiliation":[{"name":"Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna","place":["Bologna, Italy"]},{"name":"Department of Diagnostic and Interventional Radiology, Charit\u00e9 Universit\u00e4tsmedizin Berlin","place":["Berlin, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernardo","family":"Proner","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Charit\u00e9 Universit\u00e4tsmedizin Berlin","place":["Berlin, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo Alexander","family":"Auer","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Charit\u00e9 Universit\u00e4tsmedizin Berlin","place":["Berlin, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian Nima","family":"Fleckenstein","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Charit\u00e9 Universit\u00e4tsmedizin Berlin","place":["Berlin, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Giurazza","sequence":"additional","affiliation":[{"name":"Department of Vascular and Interventional Radiology, Cardarelli Hospital","place":["Naples, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Roccatagliata","sequence":"additional","affiliation":[{"name":"Department of Vascular and Interventional Radiology, Cardarelli Hospital","place":["Naples, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Carruba","sequence":"additional","affiliation":[{"name":"Department of Vascular and Interventional Radiology, Cardarelli Hospital","place":["Naples, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romaric","family":"Loffroy","sequence":"additional","affiliation":[{"name":"Department of Vascular and Interventional Radiology, Fran\u00e7ois-Mitterrand University Hospital","place":["Dijon, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Collettini","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Charit\u00e9 Universit\u00e4tsmedizin Berlin","place":["Berlin, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1186\/cc3779","article-title":"The epidemiology and modern management of traumatic hemorrhage: uS and international perspectives","volume":"9","author":"Kauvar","year":"2005","journal-title":"Crit Care"},{"key":"B2","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1001\/jama.2015.12","article-title":"Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial","volume":"313","author":"Holcomb","year":"2015","journal-title":"JAMA"},{"key":"B3","doi-asserted-by":"publisher","first-page":"852","DOI":"10.1111\/jth.14450","article-title":"Trauma-induced coagulopathy: the past, present, and future","volume":"17","author":"Kornblith","year":"2019","journal-title":"J Thromb Haemost"},{"key":"B4","doi-asserted-by":"publisher","first-page":"S69","DOI":"10.1097\/TA.0b013e31819d85fb","article-title":"Warm fresh whole blood is independently associated with improved survival for patients with combat-related traumatic injuries","volume":"66","author":"Spinella","year":"2009","journal-title":"J Trauma"},{"key":"B5","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/j.anclin.2018.09.009","article-title":"Advanced trauma life support(\u00ae) update 2019: management and applications for adults and special populations","volume":"37","author":"Galvagno Jr","year":"2019","journal-title":"Anesthesiol Clin"},{"key":"B6","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1097\/00005373-200208000-00019","article-title":"A prospective study on the safety and efficacy of angiographic embolization for pelvic and visceral injuries","volume":"53","author":"Velmahos","year":"2002","journal-title":"J Trauma Acute Care Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"107859","DOI":"10.1016\/j.jvir.2025.09.030","article-title":"Material matters: a systematic review and meta-analysis of the effectiveness of different embolic agents in middle meningeal artery embolization","volume":"37","author":"Gupta","year":"2025","journal-title":"J Vasc Interv Radiol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"500","DOI":"10.1007\/s11604-014-0328-7","article-title":"Guidelines for the use of NBCA in vascular embolization devised by the committee of practice guidelines of the Japanese society of interventional radiology (CGJSIR), 2012 edition","volume":"32","author":"Takeuchi","year":"2014","journal-title":"Jpn J Radiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"4320","DOI":"10.3390\/jcm10194320","article-title":"Endovascular use of cyanoacrylate-lipiodol mixture for peripheral embolization: properties, techniques, pitfalls, and applications","volume":"10","author":"Comby","year":"2021","journal-title":"J Clin Med"},{"key":"B10","doi-asserted-by":"publisher","first-page":"98","DOI":"10.5152\/dir.2018.17432","article-title":"N-butyl cyanoacrylate embolotherapy: techniques, complications, and management","volume":"24","author":"Hill","year":"2018","journal-title":"Diagn Interv Radiol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1007\/s00270-025-04200-w","article-title":"CIRSE Standards of practice for the classification of complications: the modified CIRSE classification system","volume":"49","author":"Filippiadis","year":"2026","journal-title":"Cardiovasc Intervent Radiol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1282","DOI":"10.3390\/biomedicines9091282","article-title":"In Vivo experimental endovascular uses of cyanoacrylate in non-modified arteries: a systematic review","volume":"9","author":"Guillen","year":"2021","journal-title":"Biomedicines"},{"key":"B13","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/j.jmbbm.2017.01.003","article-title":"Polymerization kinetics of n-butyl cyanoacrylate glues used for vascular embolization","volume":"69","author":"Li","year":"2017","journal-title":"J Mech Behav Biomed Mater"},{"key":"B14","doi-asserted-by":"publisher","first-page":"2746","DOI":"10.1007\/s00330-024-11102-x","article-title":"Trans-arterial embolization for treatment of acute lower gastrointestinal bleeding-a multicenter analysis","volume":"35","author":"Hosse","year":"2025","journal-title":"Eur Radiol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1176","DOI":"10.1016\/j.jvir.2009.06.005","article-title":"Evaluation of transcatheter arterial embolization with gelatin sponge particles, microcoils, and n-butyl cyanoacrylate for acute arterial bleeding in a coagulopathic condition","volume":"20","author":"Yonemitsu","year":"2009","journal-title":"J Vasc Interv Radiol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1007\/s00270-011-0162-6","article-title":"Transcatheter arterial embolization of intramuscular active hemorrhage with N-butyl cyanoacrylate","volume":"35","author":"Yoo","year":"2012","journal-title":"Cardiovasc Intervent Radiol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"216","DOI":"10.5152\/dir.2019.19348","article-title":"Transarterial embolization with n-butyl cyanoacrylate for the treatment of abdominal wall hemorrhage","volume":"26","author":"Albuquerque","year":"2020","journal-title":"Diagn Interv Radiol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1186\/s42155-021-00222-w","article-title":"Transarterial embolization with n-butyl cyanoacrylate for the treatment of active abdominopelvic bleeding in the polytraumatized patient","volume":"4","author":"de Freitas","year":"2021","journal-title":"CVIR Endovasc"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e20467","DOI":"10.1097\/MD.0000000000020467","article-title":"Successful superselective embolization with n-butyl cyanoacrylate for hemorrhage from superficial femoral artery branches following blunt trauma: three case reports","volume":"99","author":"Oh","year":"2020","journal-title":"Medicine"},{"key":"B20","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1258\/ar.2012.110595","article-title":"Transcatheter renal artery embolization with N-butyl cyanoacrylate","volume":"53","author":"Kim","year":"2012","journal-title":"Acta Radiol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1554","DOI":"10.1007\/s12070-023-04357-1","article-title":"Endovascular embolization of traumatic vessel injury using N-butyl cyanoacrylate: a case series","volume":"76","author":"Morsi","year":"2024","journal-title":"Indian J Otolaryngol Head Neck Surg"}],"container-title":["Frontiers in Radiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fradi.2026.1878048\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T14:47:57Z","timestamp":1782398877000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fradi.2026.1878048\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,25]]},"references-count":21,"alternative-id":["10.3389\/fradi.2026.1878048"],"URL":"https:\/\/doi.org\/10.3389\/fradi.2026.1878048","relation":{},"ISSN":["2673-8740"],"issn-type":[{"value":"2673-8740","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,25]]},"article-number":"1878048"}}