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Ethanol-soaked gelatin sponge (ESG) is a clinician-prepared embolic agent used in interventional radiology, specifically for transarterial embolization (TAE). It combines the mechanical occlusive properties of a gelatin sponge with the chemical sclerosing effects of absolute ethanol. The gelatin sponge acts as a scaffold that delivers ethanol directly to the target vessel, where ethanol induces protein denaturation, endothelial damage, and rapid thrombosis. This combination is primarily utilized to treat hepatic arterioportal shunts (APS) or fistulas (APF) in patients with hepatocellular carcinoma (HCC), effectively reducing shunt flow to improve the efficacy of subsequent transarterial chemoembolization (TACE) and patient survival outcomes.
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