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Comparative Analysis of the Risk of Rebleeding between Catheter Angiography and Colonoscopy Following a Positive

Jihye Park1, Seo Yoon Choi1, Soo Jung Park1

  • 1Department of Internal Medicine, Institute of Gastroenterology, Center of Inflammatory Bowel Disease, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Gut and Liver
|August 8, 2025
PubMed

Insights

Catheter angiography is associated with a lower rebleeding rate than colonoscopy for severe lower gastrointestinal bleeding after positive computed tomography angiography (CTA) scans. Early procedures improve outcomes.

Area of Science:

  • Gastroenterology
  • Interventional Radiology
  • Medical Diagnostics

Background:

  • Severe lower gastrointestinal bleeding diagnosis often follows computed tomography angiography (CTA).
  • Limited comparative data exist for catheter angiography versus colonoscopy post-CTA.
  • This study addresses the clinical outcomes of these endoscopic and angiographic interventions.

Purpose of the Study:

  • To compare clinical outcomes between catheter angiography and colonoscopy.
  • To identify risk factors for rebleeding after positive CTA in lower gastrointestinal bleeding.
  • To evaluate the impact of procedural timing on diagnostic and therapeutic yields.

Main Methods:

  • Retrospective analysis of 254 patients with positive lower GI CTA results.
  • Comparison of outcomes between catheter angiography (n=108) and colonoscopy (n=146) groups.
  • Logistic and Cox regression analyses to determine predictive factors for rebleeding.

Main Results:

  • No significant differences in confirmation or therapeutic yields, or hospitalization duration.
  • Catheter angiography showed shorter mean time to procedure and lower rebleeding rates.
  • Receiving >5 units of packed red blood cells and undergoing colonoscopy were significant risk factors for rebleeding.

Conclusions:

  • Colonoscopy is a significant risk factor for rebleeding compared to catheter angiography.
  • Extensive blood transfusion requirements (>5 units PRBCs) predict rebleeding.
  • Timely intervention post-CTA is crucial for managing severe lower gastrointestinal bleeding.
Abstract

Keywords:
AngiographyColonoscopyComputed tomographyGastrointestinal hemorrhageTreatment outcome

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