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Evaluation of transarterial embolization for lower gastrointestinal bleeding
M A Luchtefeld1, A J Senagore, M Szomstein
1Digestive Disease Services, The Ferguson Clinic-Spectrum Health-Ferguson Center, Grand Rapids, Michigan, USA.
Diseases of the Colon and Rectum
|May 2, 2000
Summary
Transcatheter arterial embolization (TAE) is a safe and effective treatment for massive lower gastrointestinal bleeding, especially for patients unsuitable for surgery. This procedure shows an 82% success rate in controlling hemorrhage.
Area of Science:
- Interventional Radiology
- Gastroenterology
- Vascular Surgery
Background:
- Transcatheter arterial embolization (TAE) is a recognized treatment for lower gastrointestinal bleeding.
- Advancements in selective arteriography have improved the safety and efficacy of TAE.
- Re-evaluation of TAE's role in managing lower GI bleeding is warranted.
Purpose of the Study:
- To assess the safety and success rate of transcatheter arterial embolization (TAE) for lower gastrointestinal bleeding.
- To identify common causes of lower GI bleeding treated with TAE.
- To evaluate clinical outcomes and complications associated with TAE.
Main Methods:
- Retrospective chart review of patients undergoing arteriography for lower GI bleeding at two hospitals.
- Analysis of bleeding causes, clinical outcomes, and TAE-related complications.
- Data collected on transfusion requirements and need for surgical intervention.
Main Results:
- 26 bleeding sites identified in the colon and small bowel; diverticulosis was the most common cause (12 patients).
- TAE was attempted in 17 bleeding episodes across 16 patients, achieving an 82% success rate (14 cases).
- Two patients required surgery, one for colonic necrosis and one for persistent bleeding; two deaths occurred, unrelated to TAE.
Conclusions:
- Transcatheter arterial embolization is a safe and successful option for massive lower gastrointestinal hemorrhage.
- TAE is an excellent therapeutic choice for patients with lower GI bleeding who are poor surgical candidates.
- The precise role of TAE in patients suitable for surgery requires further definition.