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Provocative angiography for lower gastrointestinal bleeding

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Abstract

Purpose

This study evaluated the results of provocative angiography performed to identify the site of hemorrhage in lower gastrointestinal bleeding to enable transcatheter arterial embolization.

Materials and methods

The subjects of this study were 11 patients with acute lower gastrointestinal bleeding who underwent provocative angiography, after contrast agent extravasation could not be identified during conventional angiography. One patient underwent provocative angiography twice, making 12 cases of provocative angiography that were analyzed in this study. Urokinase was used in all cases. Heparin was administered in 2 cases, nicardipine in 3 cases, and alprostadil and isosorbide in 1 case each.

Results

Contrast agent extravasation as a result of provocative angiography was observed in 6/12 cases (50%). Selective transcatheter arterial embolization was performed in all 6 cases in which extravasation was apparent, and it was technically successful in all six. Clinical success was achieved in 5 (83.3%) of the 6 cases in which technical success was achieved after provocative angiography.

Conclusion

Provocative angiography enabled the site of lower gastrointestinal bleeding to be identified in 6 of 12 cases (50.0%) when it could not be identified by conventional angiography, and in all 6 cases hemostasis was effectively achieved by embolization.

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Authors and Affiliations

  1. Department of Radiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 5731010, Japan

    Shuji Kariya, Miyuki Nakatani, Yasuyuki Ono, Takuji Maruyama, Yutaka Ueno, Asami Yoshida, Atsushi Komemushi & Noboru Tanigawa

Authors
  1. Shuji Kariya
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  2. Miyuki Nakatani
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  3. Yasuyuki Ono
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  4. Takuji Maruyama
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  5. Yutaka Ueno
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  6. Asami Yoshida
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  7. Atsushi Komemushi
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  8. Noboru Tanigawa
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Corresponding author

Correspondence to Shuji Kariya.

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All authors have no financial disclosure. All authors have no conflicts of interest.

Ethical approval

The study protocols for this retrospective analysis were approved by our institutional review board.

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Cite this article

Kariya, S., Nakatani, M., Ono, Y. et al. Provocative angiography for lower gastrointestinal bleeding. Jpn J Radiol 38, 248–255 (2020). https://doi.org/10.1007/s11604-019-00909-0

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  • DOI: https://doi.org/10.1007/s11604-019-00909-0

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