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Inferior vena cava diameter on CT angiography predicts mesenteric angiography positive for extravasation in colonic diverticular bleeding

  • Vascular and Interventional Radiology
  • Published:
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Abstract

Purpose

Transcatheter arterial embolization (TAE) for colonic diverticular bleeding (CDB), an established procedure for hemostasis, is sometimes complicated by spontaneous hemostasis and unclear bleeding site on angiography despite active arterial bleeding on preoperative computed tomography angiography (CTA). Therefore, to investigate and increase the feasibility of TAE, this retrospective study evaluates the clinical and radiological features related to positive extravasation on angiography.

Material and methods

Sixty CDB patients with extravasation on CTA underwent TAE between January 2011 and February 2021 and were divided into extravasation-positive (P-group; n = 25) and -negative groups (N-group; n = 35) based on the superior or inferior mesenteric angiography. Patient characteristics, laboratory findings, the diameter of the inferior vena cava (IVCD), the diameter of superior and inferior mesenteric veins, and technical outcomes were evaluated.

Results

TAE was successful in 24 patients in the P-group (96%) and 14 in the N-group (40%) (p < 0.001). Univariate analysis revealed “usage of anticoagulant” (p < 0.05) and “larger IVCD (p < 0.05) on preoperative CTA” to be significant predictors of positive extravasation. In the multivariate analysis, IVCD remained significant with an adjusted odds ratio of 1.17. The IVCD cutoff value was 13.6 mm (area under the curve = 0.72, sensitivity = 84.0%, specificity = 54.3%). There were no significant differences in other parameters.

Conclusion

Measurement of IVCD in CDB with the cutoff value of 13.6 mm can be a simple and useful indicator to predict the detectability of extravasation following TAE procedures.

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Acknowledgements

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Department of Radiology, Jikei University Hospital, Jikei University, 3-19-18, Nishishinbashi, Minato-ku, Tokyo, Japan

    Yosuke Nozawa, Kenkichi Michimoto, Hirokazu Ashida, Akira Baba, Takeshi Fukuda & Hiroya Ojiri

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  1. Yosuke Nozawa
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  2. Kenkichi Michimoto
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  3. Hirokazu Ashida
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  4. Akira Baba
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  5. Takeshi Fukuda
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  6. Hiroya Ojiri
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by YN, KM, HA, TF, AB, and HO. The first draft of the manuscript was written by YN and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Yosuke Nozawa.

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The authors declare no conflicts of interest associated with this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The institutional review boards of the participating institutions approved this retrospective study.

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The need for documentation of informed consent was waived. Informed consent was obtained in the form of opt-out on the Web site [Approval Number: 32–494(105879)].

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Consent for publication was obtained for every individual person’s data included in the study.

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Nozawa, Y., Michimoto, K., Ashida, H. et al. Inferior vena cava diameter on CT angiography predicts mesenteric angiography positive for extravasation in colonic diverticular bleeding. Radiol med 127, 1412–1419 (2022). https://doi.org/10.1007/s11547-022-01564-8

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