Superselective embolization of lower gastrointestinal hemorrhage: a new paradigm

In the past 5 years, there has been a rapid evolution in the endovascular treatment of lower gastrointestinal bleeding. Previously, most bleeding distal to the ligament of Treitz was managed with catheter-directed vasoconstrictive therapy. Currently, microcatheters allow superselective embolization of bleeding vessels, a technique that minimizes potential ischemic complications and obviates many drawbacks associated with vasopressin infusion. This article summarizes the current radiologic approach for patients with severe colonic hemorrhage.