Ultraselective embolization using a 1.7-Fr catheter and soft bare coil for small intestinal bleeding

Area of Science:

• Gastroenterology
• Interventional Radiology
• Vascular Surgery

Background:

• Acute small intestinal bleeding presents a diagnostic and therapeutic challenge.
• Traditional treatment options may be invasive or have limited efficacy.

Purpose of the Study:

• To evaluate the safety and efficacy of embolization for acute small intestinal bleeding.
• To assess the use of a 1.7-Fr catheter and soft bare coils in this procedure.

Main Methods:

• Five patients with melena and small intestinal bleeding underwent transcatheter arterial embolization.
• A 1.7-Fr catheter and 0.010-inch detachable bare coils were used.
• Capsule endoscopy was employed for technical and clinical success assessment, complication evaluation, and bleeding source identification.

Main Results:

• 100% technical and clinical success was achieved in all five embolization procedures.
• Catheterization of vasa recta was successful using the 1.7-Fr catheter.
• No rebleeding, intestinal ischemia, or necrosis occurred post-procedure.
• Peptic ulcers or ulcer scars were identified as the cause of bleeding in all cases.

Conclusions:

• Embolization with 0.010-inch coils and a 1.7-Fr catheter is a safe and effective treatment for acute small intestinal bleeding.
• This technique allows for successful catheterization of bleeding vasa recta.
• The procedure demonstrated high efficacy, even in patients with coagulopathy.