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European Radiology

, Volume 29, Issue 1, pp 57–67 | Cite as

Transcatheter arterial embolisation for acute lower gastrointestinal haemorrhage: a single-centre study

  • Joon Ho Kwon
  • Man-Deuk KimEmail author
  • Kichang Han
  • Woosun Choi
  • Yong Seek Kim
  • Junhyung Lee
  • Gyoung Min Kim
  • Jong Yun Won
  • Do Yun Lee
Vascular-Interventional
  • 249 Downloads

Abstract

Objective

To investigate the safety and efficacy of transcatheter arterial embolisation (TAE) in the management of lower gastrointestinal bleeding (LGIB) and to identify predictors of clinical outcomes.

Methods

Between December 2005 and April 2017, 274 patients underwent diagnostic angiography for signs and symptoms of LGIB; 134 patients with positive angiographic findings were retrospectively analysed. The technical success of TAE and clinical outcomes, including recurrent bleeding, major complications, and in-hospital mortality were evaluated. The associations of various clinical and technical factors with clinical outcomes were analysed. Predictors for clinical outcomes were evaluated using univariate and multivariate logistic regression analyses.

Results

A total of 134 patients (mean age, 59.7 years; range, 14–82 years) underwent TAE for LGIB. The bleeding foci were in the small bowel in 74 patients (55.2%), colon in 35 (26.1%), and rectum in 25 (18.7%). Technical success was achieved in 127 patients (94.8%). The clinical success rate was 63% (80/127). The rates of recurrent bleeding, major complications, and in-hospital mortality were 27.9% (31/111), 18.5% (23/124), and 23.6% (33/127), respectively. Superselective embolisation and the use of N-butyl cyanoacrylate (NBCA) were significant prognostic factors associated with reduced recurrent bleeding (OR, 0.258; p = 0.004 for superselective embolisation, OR, 0.313; p = 0.01 for NBCA) and fewer major complications (OR, 0.087; p ˂ 0.001 for superselective embolisation, OR, 0.272; p = 0.007 for NBCA).

Conclusions

TAE is an effective treatment modality for LGIB. Superselective embolisation is essential to reduce recurrent bleeding and avoid major complications. NBCA appears to be a preferred embolic agent.

Key Points

• Transcatheter arterial Embolisation (TAE) is a safe and effective treatment for lower gastrointestinal tract haemorrhage.

• Superselective embolisation is essential to improve outcomes.

• N-butyl cyanoacrylate (NBCA) appears to be a preferred embolic agent with better clinical outcomes.

Keywords

Gastrointestinal haemorrhage Lower gastrointestinal tract Embolisation, Therapeutic Treatment outcome Postoperative Complications 

Abbreviations

CT

Computed tomography

GIB

Gastrointestinal bleeding

IIA

Internal iliac artery

IMA

Inferior mesenteric artery

LGIB

Lower gastrointestinal bleeding

NBCA

N-butyl cyanoacrylate

PVA

Polyvinyl alcohol

SMA

Superior mesenteric artery

TAE

Transcatheter arterial embolisation

Notes

Funding

The author state that this work has not received any funding.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Man-Deuk Kim, Severance hospital, Yonsei University.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• observational

• performed at one institution

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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Department of Radiology, Severance Hospital, Research Institute of Radiological ScienceYonsei University College of MedicineSeoulKorea

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