Reteplase provocative visceral arteriography

Area of Science:

• Gastroenterology
• Interventional Radiology
• Vascular Medicine

Background:

• Acute lower gastrointestinal hemorrhage (LGIB) often stops spontaneously.
• Provocative visceral arteriography aids in diagnosing recurrent LGIB without an identifiable source.
• Previous fibrinolytic agents yielded limited diagnostic success (33-37.5%).

Purpose of the Study:

• To evaluate a novel provocative visceral arteriography protocol.
• To assess the efficacy and safety of Reteplase as a fibrinolytic agent in this context.

Main Methods:

• Retrospective analysis of 9 patients with recurrent, massive LGIB.
• Administration of Reteplase (5 units over 1 minute) into mesenteric arteries.
• Repeat arteriography performed 5-10 minutes post-Reteplase administration.

Main Results:

• Successful induction of colonic hemorrhage in 89% of patients.
• No procedure-related complications were observed.
• Effective localization of bleeding sites in a majority of cases.

Conclusions:

• Reteplase demonstrates potential as a safe and effective provocative agent for diagnosing occult, recurrent, massive LGIB.
• This new protocol may improve diagnostic yield in challenging cases.
• Further research is warranted to confirm these findings.