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Provocative angiography for lower gastrointestinal bleeding.

Shuji Kariya1, Miyuki Nakatani2, Yasuyuki Ono2

  • 1Department of Radiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 5731010, Japan. kariyas@hirakata.kmu.ac.jp.

Japanese Journal of Radiology
|December 14, 2019
PubMed
Summary

Provocative angiography identified the source of lower gastrointestinal bleeding in 50% of cases when conventional angiography failed. This allowed for successful transcatheter arterial embolization and hemostasis in all identified bleeding sites.

Keywords:
DiverticulumEmbolizationGastrointestinal bleedingPharmacoangiographyProvocative angiography

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Area of Science:

  • Interventional Radiology
  • Gastroenterology

Background:

  • Lower gastrointestinal bleeding (LGIB) can be challenging to localize.
  • Conventional angiography may fail to identify the bleeding source.

Purpose of the Study:

  • To evaluate the efficacy of provocative angiography in identifying hemorrhage sites in LGIB.
  • To assess the subsequent success of transcatheter arterial embolization (TAE).

Main Methods:

  • 12 cases of provocative angiography were analyzed in 11 patients with acute LGIB.
  • Contrast agent extravasation was assessed after provocative angiography.
  • TAE was performed in cases with identified extravasation.

Main Results:

  • Provocative angiography identified contrast extravasation in 6/12 cases (50%).
  • Technical success of TAE was achieved in all 6 cases where embolization was performed.
  • Clinical success of TAE was 83.3% (5/6 cases).

Conclusions:

  • Provocative angiography is effective in localizing obscure LGIB sites.
  • Successful embolization can be achieved in all cases where the bleeding source is identified by provocative angiography.