Predictors for outcomes after super-selective mesenteric embolization for lower gastrointestinal tract bleeding

Area of Science:

• Interventional Radiology
• Gastroenterology
• Vascular Surgery

Background:

• Optimal management for lower gastrointestinal bleeding (LGIB) remains debated.
• Mesenteric embolization is a potential therapeutic option for LGIB.

Purpose of the Study:

• To assess the efficacy of mesenteric embolization for LGIB.
• To identify predictors of re-bleeding after mesenteric embolization.

Main Methods:

• Retrospective review of 26 patients undergoing mesenteric embolization for LGIB (August 2007 - August 2013).
• Technical success: absence of contrast extravasation post-embolization.
• Clinical success: no overt LGIB within 30 days post-embolization.

Main Results:

• 100% technical success with no post-embolization ischemia.
• 65.4% clinical success rate; 9 patients re-bled within 30 days.
• Platelet count ≤140 × 10(9)/L pre-embolization was a significant predictor of re-bleeding (OR=17.5, P=0.004).

Conclusions:

• Mesenteric embolization is safe and effective for LGIB, with high technical success.
• 65.4% of patients did not require further intervention.
• Low pre-embolization platelet count is associated with clinical failure and re-bleeding.