Clinical Outcome of the Visible Coil During Endoscopy After Transcatheter Arterial Embolization for Gastrointestinal Bleeding

• Published in: Cardiovascular and interventional radiology Vol. 42; no. 11; pp. 1537 - 1544
• Main Authors: Shim, Jong-Joon, Chu, Hee Ho, Shin, Ji Hoon, Kim, Jong Woo, Kim, Do Hoon, Jung, Hwoon-Yong, Ahn, Ji Yong
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.11.2019; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Angiography; Arterial Interventions; ARTERIES; BIOMEDICAL RADIOGRAPHY; Bleeding; Cardiology; Clinical Investigation; Clinical outcomes; DESIGN; Embolization; Embolization, Therapeutic - methods; Endoscopy; Endoscopy - methods; EVALUATION; Female; Gastrointestinal Hemorrhage - therapy; HEALING; Humans; Imaging; Intestine; Male; MEDICAL RECORDS; Medicine; Medicine & Public Health; Middle Aged; Migration; Nuclear Medicine; PATHOLOGY; PATIENTS; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; Retrospective Studies; REVIEWS; Success; Treatment Outcome; ULCERS; Ultrasound; VASCULAR DISEASES; Transcatheter arterial embolization; Extravascular coil; Endoscopy; Gastrointestinal bleeding
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-019-02258-x

Purpose This study was designed to evaluate the clinical outcome of the visible coil during endoscopy after transcatheter arterial embolization (TAE) for gastrointestinal bleeding. Methods We retrospectively reviewed the medical records of 1415 patients who underwent TAE for gastrointestinal bleeding between 2001 and 2017. Among these 1415 patients, 70 underwent TAE using coils and consecutive follow-up endoscopy. Finally, 11 patients with an extravascular coil seen on follow-up endoscopic examination were included in this study. We evaluated the underlying cause of the gastrointestinal bleeding, the technical and clinical success rates, the type of extravascular coil after TAE, and the clinical outcomes of the extravascular coil seen on follow-up endoscopic examination. Results Of the 11 patients, the most common underlying cause of gastrointestinal bleeding was a duodenal ulcer ( n  = 7). On angiography, the bleeding artery was most commonly found in the gastroduodenal artery ( n  = 6). The technical success and clinical success rates of TAE were 100% and 90.9%, respectively. The type of extravascular coil found on endoscopic examination was classified by submucosal migration ( n  = 6) and protrusion ( n  = 5). On second-look endoscopic evaluation, 10 of 11 (90.9%) patients showed healing ulceration. On the final-look endoscopic evaluation, healing ulceration without further bleeding was seen in one (9.1%) patient and scar formation was seen in ten (90.9%) patients. Conclusions Extravascular coil after TAE for gastrointestinal bleeding is rare, and the most common underlying cause is duodenal ulcer bleeding. The extravascular coils eventually show a healing process with adequate treatment of underlying bowel pathologies.