Rectal Venous Malformation Treated by Superior Rectal Artery Embolization

• Published in: Cardiovascular and interventional radiology Vol. 42; no. 1; pp. 154 - 157
• Main Authors: El-Sheikha, J., Little, M. W., Bratby, M.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.01.2019; Springer Nature B.V
• Subjects: Activities of daily living; Adult; Anemia; ARTERIES; BIOMEDICAL RADIOGRAPHY; Bleeding; Blood flow; Cardiology; Case Report; Colon; Embolization; Embolization, Therapeutic - methods; Female; Fluoroscopy; HEMORRHAGE; Humans; Imaging; Intestine; INTRAVENOUS INJECTION; Klippel-Trenaunay-Weber Syndrome - complications; Klippel-Trenaunay-Weber Syndrome - diagnostic imaging; Klippel-Trenaunay-Weber Syndrome - therapy; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; MALFORMATIONS; Medicine; Medicine & Public Health; NMR; NMR IMAGING; Nuclear magnetic resonance; Nuclear Medicine; PATIENTS; PELVIS; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; RECTUM; Rectum - blood supply; Rectum - diagnostic imaging; Reduction; Thickening; Thigh; Treatment Outcome; Ultrasonography, Interventional - methods; Ultrasound; VASCULAR DISEASES; Vascular Malformations - diagnostic imaging; Vascular Malformations - etiology; Vascular Malformations - therapy; Varicose; Embolization; Venous malformation; Klippel–Trenaunay syndrome; KTS
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-018-2067-0

A 25-year-old female was referred to the Interventional Radiology Department for investigation and treatment of a rectal venous malformation (RVM) causing large recurrent episodes of rectal bleeding and chronic anaemia. Magnetic resonance imaging (MRI) demonstrated a large venous malformation affecting the rectum, lower pelvis and left thigh. After three failed attempts at injection foam sclerotherapy using fluoroscopic colonoscopy, a multidisciplinary team proposed an embolization procedure of the arterial inflow to the venous malformation. Following discussion with the patient, embolization of the superior rectal arteries was undertaken with immediate on-table fluoroscopic improvement in the RVM. Post-treatment, a significant reduction in bleeding, was reported by day 10 with subsequent return to activities of daily living and full employment. Follow-up MRI at 1 year demonstrated significant reduction in bowel-wall thickening.