Percutaneous Embolotherapy of Lower Gastrointestinal Hemorrhage

Peck, David; McLoughlin, Raymond F.; Rankin, Richard N.

doi:10.1016/s1051-0443(98)70386-0

Cited by 104 publications

(44 citation statements)

References 15 publications

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“…b Following flowdirected PVA particle embolization, no contrast extravasation is demonstrated embolization. Five studies detailed in Table 2 [59,61,64,66,70] have an intention to treat design, reporting both the total number of patients in whom superselective embolization is attempted, as well as the technical success of these interventions. In the Bandi study, where 73% technical feasibility is reported, only the branch of the vasa recta supplying the hemorrhage is embolized [64].…”

Section: Outcomes Of Embolizationmentioning

confidence: 99%

Interventional management of lower gastrointestinal bleeding

et al. 2008

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Lower gastrointestinal bleeding (LGIB) arises from a number of sources and is a significant cause of hospitalization and mortality in elderly patients. Whereas most episodes of acute LGIB resolve spontaneously with conservative management, an important subset of patients requires further diagnostic workup and therapeutic intervention. Endovascular techniques such as microcatheter embolization are now recognized as safe, effective methods for controlling LGIB that is refractory to endoscopic intervention. In addition, multidetector CT has shown the ability to identify areas of active bleeding in a non-invasive fashion, enabling more focused intervention. Given the relative strengths and weaknesses of various diagnostic and treatment modalities, a close working relationship between interventional radiologists, gastroenterologists and diagnostic radiologists is necessary for the optimal management of LGIB patients.

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Section: Outcomes Of Embolizationmentioning

confidence: 99%

Interventional management of lower gastrointestinal bleeding

et al. 2008

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“…Several recent reports describe the safety and efficacy of super-selective angioembolization, but the long-term outcomes after selective embolization remain poorly evaluated [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Transarterial embolization in acute colonic bleeding: review of 11 years of experience and long-term results

Rossetti

Buchs

Bréguet

et al. 2012

Int J Colorectal Dis

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Background Lower gastrointestinal bleeding represents 20 % of all gastrointestinal bleedings. Interventional radiology has transformed the treatment of this pathology, but the long-term outcome after selective embolization has been poorly evaluated. The aim of this study is thus to evaluate the short-term and long-term outcomes after selective embolization for colonic bleeding.Methods From November 1998 to December 2010, all acute colonic embolizations for hemorrhage were retrospectively reviewed and analyzed. The risk factors for post-embolization ischemia were also assessed. Results Twenty-four patients underwent colonic embolization. There were 6 men and 18 women with a median age of 80 years (range, 42-94 years). The underlying etiologies included diverticular disease (41.9 %), post-polypectomy bleeding (16.7 %), malignancy (8.2 %), hemorrhoid (4.1 %), and angiodysplasia (4.1 %). In 23 patients, bleeding stopped (95.8 %) after selective embolization. One patient presented a recurrence of bleeding with hemorrhagic shock and required urgent hemorrhoidal ligature. Four patients required an emergent surgical procedure because of an ischemic event (16.7 %). One patient died of ileal ischemia (mortality, 4.1 %). The level of embolization and the length of hypoperfused colon after embolization were the only risk factors for emergent operation. Mean hospital stay was 18 days (range, 9-44 days). After a mean follow-up of 28.6 months (range, 4-108 months), no other ischemic events occurred. Conclusion In our series, selective transarterial embolization for acute colonic bleeding was clinically effective with a 21 % risk of bowel ischemia. The level of embolization and the length of the hypoperfused colon after embolization should be taken into consideration for emergent operation.

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“…Difficulties in the precise deployment and incomplete control of the distal blood flow can be attributed to clinical failure. In some cases, supplementary embolization using PVA particles or a gelatin sponge may be necessary to consolidate the coilembolized artery after microcoil deployment (2,(29)(30)(31)(32). In our series, a gelatin sponge was used as the supplementary embolic material in 16 patients.…”

Section: Discussionmentioning

confidence: 94%