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Imipenem/Cilastatin Sodium as Reabsorbable Embolic Agent in Acute Lower Gastrointestinal Bleeding: A Multicentric
Pietro Roccatagliata1, Francesco Giurazza1, Andrea Discalzi2
1Vascular and Interventional Radiology Department, Cardarelli Hospital, Via Antonio Cardarelli 9, 80131 Naples, Italy.
Diagnostics (Basel, Switzerland)
|August 13, 2026
Summary
Imipenem/cilastatin sodium (IPM/CS) shows promise as an off-label embolic agent for acute lower gastrointestinal bleeding (LGIB). This study found IPM/CS to be safe and effective, with a high clinical success rate and no related complications.
Area of Science:
- Interventional Radiology
- Gastroenterology
- Vascular Surgery
Background:
- Acute lower gastrointestinal bleeding (LGIB) poses significant clinical challenges.
- Endovascular embolization is a key treatment modality for acute LGIB.
- Novel embolic agents are continuously being investigated for improved safety and efficacy.
Purpose of the Study:
- To evaluate the safety and effectiveness of imipenem/cilastatin sodium (IPM/CS) as an off-label embolic agent for acute LGIB.
- To assess the technical and clinical success rates of IPM/CS embolization.
- To determine the complication profile and long-term outcomes of IPM/CS use in LGIB.
Main Methods:
- A multicentric prospective study involving 21 patients with acute LGIB.
- Endovascular embolization using IPM/CS particles prepared with iodine contrast agent.
- Inclusion criteria focused on emergency treatment, failed endoscopic management, and comprehensive pre/post-procedural assessments with 30-day follow-up.
Main Results:
- 100% technical success rate in achieving angiographic stasis or significant flow reduction.
- 85.7% clinical success rate at 30 days, indicated by improved hemoglobin and hemodynamic stability.
- No major complications or IPM/CS-related adverse events were reported; three patients experienced rebleeding.
Conclusions:
- Imipenem/cilastatin sodium (IPM/CS) demonstrated safety and feasibility as an off-label embolic agent in selected acute LGIB patients.
- No instances of bowel ischemia were observed during the 30-day follow-up period.
- Larger studies are warranted to validate IPM/CS as an alternative embolic option for LGIB.
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