Acute lower gastrointestinal hemorrhage: treatment by transcatheter embolization

This poster was previously presented in Spanish at the 2012 Congreso Nacional SERAM (Granada)

Congress:

ECR 2013

Poster Number:

C-1545

Type:

Scientific Exhibit

Keywords:

Haemorrhage, Embolisation, Catheter arteriography, Interventional vascular, Emergency, Arteries / Aorta

Authors:

M. Echenagusia Boyra, M. González Leyte, G. Rodriguez Rosales, F. Camúñez Alonso, A. E. Madrid Vallenilla, N. Mimika Haasz; Madrid/ES

DOI:

10.1594/ecr2013/C-1545

DOI-Link:

https://dx.doi.org/10.1594/ecr2013/C-1545

Fig. 1: Location

Fig. 2: Embolic agent

Fig. 3: Results

Fig. 4: Case 1

Purpose

To evaluate the efficacy of transarterial embolization in acute lower intestinal bleding

Methods and Materials

Ten patients with acute lower gastrointestinal bleeding were treated with superselective transcatheter arterial embolization at our institution. There were several bleeding causes: previous surgery (n = 3), diverticular bleeding (n = 2), arteriovenous malformation (n = 2), ulcerative colitis (n = 1), and ulcer caused by an enteral feeding catheter (n = 1). In one patient no cause was identified. In 7 of 10 patients a CT angiography was performed before conventional angiography and embolization. In all cases superselective catheterization with microcatheter was performed to...

Results

Extravasations were found out in all the10 patients within the initial mesenteric angiogram (either superior or inferior mesenteric artery). Nine of ten patients underwent superior mesenteric artery branch catheterization and one underwent inferior mesenteric artery branch catheterization. The following bleeding sites were identified: jejunal branch (n = 4), branch of right colic artery (n = 2), branch of ileocolic artery (n = 2), ileal branch (n = 1), and branch of sigmoid artery (n = 1). Technical success, defined as no bleeding signs in angiography...

Conclusion

Superselective arterial embolization is a safe and effective technique in the treatment of acute lower gastrointestinal bleeding.

References

1.- Kickuth R, Rattunde H, Gschossman J. Acute Lower Gastrointestinal Hemorrhage: Minimally Invasive Management with Microcatheter Embolization. J Vasc Interv Radiol. 2008; 19: 1289-1296. 2.- BandiR, ShettyPC, SharmaRP, BurkeTH, BurkeMW, KastanD.Superselective arterial embolization for the treatment of lower gastrointestinal hemorrhage. J Vasc Interv Radiol. 2001;12:1399–1405. 3.- FunakiB.Microcatheter embolization of lower gastrointestinal hemorrhage: an old idea whose time has come. Cardiovasc Intervent Radiol. 2004;27:591–599 4.- KhannaA, OgnibeneSJ, KoniarisLG.Embolization as first-line therapy for diverticulosis-related massive lower gastrointestinal bleeding: evidence from a meta-analysis. J Gastrointest Surg. 2005;9:343–352 5.-...