Safety and Efficacy of Transcatheter Arterial Embolization for Lower Gastrointestinal Bleeding: A Single-center Experience with 112 Patients

• Published in: Journal of vascular and interventional radiology Vol. 25; no. 1; pp. 10 - 19
• Main Authors: Hur, Saebeom, MD, Jae, Hwan Jun, MD, PhD, Lee, Myungsu, MD, Kim, Hyo-Cheol, MD, PhD, Chung, Jin Wook, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2014
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Angiography, Digital Subtraction; Embolization, Therapeutic - adverse effects; Embolization, Therapeutic - mortality; Enbucrilate - adverse effects; Enbucrilate - therapeutic use; Female; Gastrointestinal Hemorrhage - diagnostic imaging; Gastrointestinal Hemorrhage - mortality; Gastrointestinal Hemorrhage - therapy; Hemostatic Techniques - adverse effects; Hemostatic Techniques - mortality; Hospital Mortality; Humans; Male; Middle Aged; Radiology; Recurrence; Republic of Korea; Retrospective Studies; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Young Adult; lower gastrointestinal bleeding; n-butyl cyanoacrylate; OR; odds ratio; NBCA; LGIB
• ISSN: 1051-0443; 1535-7732
• DOI: 10.1016/j.jvir.2013.09.012

Abstract Purpose To 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 Methods All 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. Results A 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. Conclusions Transcatheter arterial embolization is a safe and effective treatment for LGIB. NBCA could be used as a primary embolic agent for this procedure.