Safety and Efficacy of Transcatheter Arterial Embolization for Lower Gastrointestinal Bleeding: A Single-center Experience with 112 Patients |
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| Institution: | 1. Department of Radiology, University of Virginia Health System, 1215 Lee Street, Charlottesville, VA 22908;2. Department of Vascular Surgery, University of Virginia Health System, 1215 Lee Street, Charlottesville, VA 22908;1. Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka Suita, Osaka 565-0871, Japan;2. Department of Pathology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka Suita, Osaka 565-0871, Japan;3. Laboratory of Veterinary Surgery, Department of Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan.;1. Vascular and Interventional Radiology, Jiménez Díaz Foundation University Hospital, c/ Jalón no. 11, 28221 Majadahonda, Madrid, Spain;2. Cardiac and Abdominal Radiology, Universidad Autonoma de Madrid, Madrid, Spain;1. Department of Radiology and Imaging Sciences, Division of Interventional Radiology, Emory University, Atlanta, Georgia;2. Department of Radiology, Division of Interventional Radiology, Wake Forest University, Winston-Salem, North Carolina;3. Department of Radiology, Division of Interventional Radiology, Duke University, Box 3808, 2301 Erwin Road, Durham, NC 27710 |
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| Abstract: | PurposeTo assess the safety and efficacy of transcatheter arterial embolization for lower gastrointestinal bleeding (LGIB) and to determine the prognostic factors that affect clinical outcome.Materials and MethodsAll patients diagnosed with LGIB by angiography at a single institution from April 2006 to January 2013 were included in a retrospective study. The rates of technical success, early recurrent bleeding, major complications, clinical success, and in-hospital mortality for transcatheter arterial embolization were determined. The influence of possible prognostic factors on the outcome was analyzed.ResultsA total of 112 patients were included (36 with small-bowel LGIB, 36 with colon LGIB, and 40 with rectal LGIB). N-butyl cyanoacrylate (NBCA) was the embolic agent for 84 patients (75.0%), whereas gelatin sponge pledgets (n = 20), microcoils (n = 2), polyvinyl alcohol particles with adjunctive gelatin sponge pledgets (n = 1), and blood clots (n = 1) were used in the other patients. The technical success rate was 96.4%. For the entire group, the rates of early recurrent bleeding, major complications, clinical success, and in-hospital mortality were 17.4%, 4.6%, 74.5%, and 25.0%, respectively. These were 15.2%, 4.8%, 75.3%, and 26.2%, respectively, in the NBCA group. Hematologic malignancy, immobilization status, and coagulopathy were significant prognostic factors for clinical outcomes.ConclusionsTranscatheter arterial embolization is a safe and effective treatment for LGIB. NBCA could be used as a primary embolic agent for this procedure. |
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| Keywords: | LGIB"} {"#name":"keyword" "$":{"id":"key0010"} "$$":[{"#name":"text" "_":"lower gastrointestinal bleeding NBCA"} {"#name":"keyword" "$":{"id":"key0020"} "$$":[{"#name":"text" "_":"n-butyl cyanoacrylate OR"} {"#name":"keyword" "$":{"id":"key0030"} "$$":[{"#name":"text" "_":"odds ratio |
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