The efficacy and long-term outcome of microcoil embolotherapy for acute lower gastrointestinal bleeding.

Abstract:

OBJECTIVE:To evaluate the clinical efficacy as well as long-term clinical outcomes of superselective microcoil embolization for lower gastrointestinal bleeding (LGIB). MATERIALS AND METHODS:Between 1997 and 2009, 26 patients with intended transcatheter embolotherapy for LGIB were retrospectively reviewed. Embolization was performed only when the catheter could be advanced to or distal to the mesenteric border of the bowel. The main purpose of our study was to assess technical success, recurrent bleeding rate and complications. We also evaluated the long-term clinical outcome, including late recurrent LGIB, bowel ischemia and the survival rate. RESULTS:Twenty-two bleeding sources were in the territory of superior mesenteric artery and four in the inferior mesenteric artery. Technical success was achieved in 22 patients (84.6%). The target vessel of embolization was vasa recta in seventeen patients and marginal artery in the remaining five patients. Early rebleeding occurred in two patients (7.7%) and bowel ischemia in two patients, of whom the embolized points were both at the marginal artery. Delayed recurrent bleeding (> 30 days) occurred in two angiodysplasia patients. Five patients (19.2%) died within the first 30 days of intervention. Long-term follow-up depicted estimated survival rates of 58.2 and 43.1% after one, and five years, respectively. CONCLUSION:Transcatheter embolotherapy to treat LGIB is effective with low rebleeding and ischemic complications. Considering the advanced age and complex medical problems of these patients, the minimal invasive embolotherapy may be used as both a primary and potentially definitive treatment of LGIB.

journal_name

Korean J Radiol

authors

Teng HC,Liang HL,Lin YH,Huang JS,Chen CY,Lee SC,Pan HB

doi

10.3348/kjr.2013.14.2.259

subject

Has Abstract

pub_date

2013-03-01 00:00:00

pages

259-68

issue

2

eissn

1229-6929

issn

2005-8330

journal_volume

14

pub_type

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