Embolization in the Management of Lower-Gastrointestinal Hemorrhage

Sebrechts, Christopher; Bookstein, Joseph J.

doi:10.1055/s-2008-1075928

Cited by 19 publications

(9 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Results In contrast to older techniques, which had a reported recurrence rate of 11%, 32,[36][37][38] present studies based on super-selective techniques reveal a recurrence rate of nearly 19%. 33,[39][40][41][42] This may be due to increased collateral perfusion or recanalization of the embolized artery.…”

Section: Embolizationcontrasting

confidence: 67%

Arterial Interventions in Gastrointestinal Bleeding

Cherian

Mehta

Kalyanpur

et al. 2009

Semin intervent Radiol

View full text Add to dashboard Cite

The diagnosis and management of gastrointestinal (GI) bleeding are complicated. A multitude of pathologic processes results in GI bleeding, and often, the bleeding is intermittent in nature. Of the available diagnostic tools, angiography has been the gold standard. Management of patients requires a multidisciplinary approach involving gastroenterologists, interventional radiologists, and surgeons. Therapeutic arterial interventions include pharmacologic control with the use of intraarterial vasopressin, embolization with temporary and permanent embolizing materials, and catheter-induced vasospasm.

show abstract

Section: Embolizationcontrasting

confidence: 67%

Arterial Interventions in Gastrointestinal Bleeding

Cherian

Mehta

Kalyanpur

et al. 2009

Semin intervent Radiol

View full text Add to dashboard Cite

show abstract

“…The optimal embolic procedure seems to differ depending on etiology, angiographic features, and accessibility of the proposed arteries. However, recent papers (6, 8, 11, 12, 20) including our results may justify superselective embolization of lower gastrointestinal hemorrhage.…”

Section: Discussionmentioning

confidence: 67%

“…In lower gastrointestinal embolization, embolic sites differ from a first‐order branch (10) to vasa recta (12, 17, 20). This field has been greatly affected by the advancement of catheter devices, especially microcatheters.…”

Section: Discussionmentioning

confidence: 99%

“…Embolization of lower gastrointestinal hemorrhage is believed to be effective due to sustained reduction of both blood pressure and pulse pressure in the area of hemorrhage (7). If postembolization angiogram demonstrated continued flow and normal mucosal opacification, perfusion was preserved and infarction did not occur (20).…”

Section: Discussionmentioning

confidence: 99%

“…Transcatheter arterial embolization has been advocated as an alternative to arterial infusion of vasopressin for gastrointestinal hemorrhage (4-6, 8, 10-12, 18, 20). The procedure carries the potential risks of ischemia and infarction, the latter occurring in up to 20% of patients (1,2,4,5,8,11,14,17,18,20,21,23). The significant potential for colonic infarction is based on the relatively sparse and poorly anastomosing mural arterial network of the colon (2,9,11,19).…”

mentioning

confidence: 99%

See 2 more Smart Citations

Morphologic and Histopathologic Changes in the Bowel after Super-Selective Transcatheter Embolization for Focal Lower Gastrointestinal Hemorrhage

Horiguchi¹,

Naito²,

Fukuda³

et al. 2003

Acta Radiologica

View full text Add to dashboard Cite

Purpose: To evaluate the safety of superselective arterial embolization therapy in the lower gastrointestinal tract. The sequelae on normal enteric tissue in lower gastrointestinal arterial embolization were retrospectively reviewed. Material and Methods: To control hemorrhage and tumor blood supply, 14 patients were treated by superselective transcatheter embolization at different levels of the colonic and small intestine vessels via the superior and inferior mesenteric arteries using microcoils and/or gelatin sponge. Normal enteric tissues in the embolized areas were analyzed for the occurrence of ischemic changes by clinical follow‐up, colonoscopy, and surgery. Results: Normal bowel function was preserved in 13 patients. In 1 patient treated with numerous gelatin sponge particles delivered from the proximal arcade of the superior mesenteric artery, significant muscular fibrosis occurred. Conclusion: Superselective arterial embolization for lower gastrointestinal hemorrhage can be safely performed by minimizing the amount of embolic materials and delivering them as distally as possible.

show abstract

Embolization of superior haemorrhoidal artery in the management of life-threatening rectal bleeding

Derodra

Reidy

Jourdan

1992

Journal of British Surgery

View full text Add to dashboard Cite

Angiography after proctosigmoidoscopy in the management of patients with acute lower gastrointestinal bleeding is now well established for localizing the site of such bleeding. The role of angiography in the control of lower gastrointestinal bleeding remains poorly defined. This report describes two patients with life-threatening rectal bleeding that was successfully stopped by selective embolization of the superior haemorrhoidal artery.cause hypovolaemic shock which required urgent resuscitation and blood transfusion ( 5 units). Sigmoidoscopy under epidural anaesthesia revealed a large, solitary, bleeding rectal ulcer, around which deep ligatures were passed to control the bleeding. A further massive rectal bleed occurred the next day and inferior mesenteric arteriography via the femoral artery was performed. Although this study was normal, it was decided to embolize the superior haemorrhoidal artery. Using a coaxial catheter technique and a 3-Fr Teflon (Du Pont, Stevenage, U K ) catheter, the superior haemorrhoidal artery was selectively catheterized. With the catheter tip safely beyond the sigmoid branches, the superior haemorrhoidal artery was embolized using multiple Gelfoam particles (Ferrosan, Denmark), approximately 1 mm3 in size and injected a few at a time ( Figure I ) . This successfully prevented further rectal bleeding. The patient had no further bouts of rectal bleeding and no clinical evidence of bowel ischaemia. He died from cardiac disease 4 months later. Patient 2A 76-year-old man presented with intermittent rectal bleeding and prolapse. A large rectal villous adenoma was excised locally under general anaesthesia. After this there was severe rectal bleeding from the operation site which required urgent transfusion of4 units of blood. Two attempts were made in the next 24 h to control this bleeding with ligatures, without success. Selective inferior mesenteric arteriography was performed, which demonstrated localized extravasation of contrast medium from the superior haemorrhoidal artery (Figure 2). This artery was then subselectively catheterized and embolized. Colonoscopy performed later showed no evidence of bowel ischaemia but revealed Patient 1A 64-year-old man presented with bright red rectal bleeding 4 weeks after triple coronary artery bypass graft surgery from which he had made an uncomplicated recovery. The bleeding was severe enough to

show abstract

Embolization in the Management of Lower-Gastrointestinal Hemorrhage

Cited by 19 publications

References 0 publications

Arterial Interventions in Gastrointestinal Bleeding

Arterial Interventions in Gastrointestinal Bleeding

Morphologic and Histopathologic Changes in the Bowel after Super-Selective Transcatheter Embolization for Focal Lower Gastrointestinal Hemorrhage

Embolization of superior haemorrhoidal artery in the management of life-threatening rectal bleeding

Contact Info

Product

Resources

About