Related Experiment Videos
[Endovascular embolization in gastrointestinal hemorrhage]
T E de Jong1, M van Haastert, J H Bergmann
1Afd. Radiodiagnostiek, Martini Ziekenhuis, locatie Van Swieten, Groningen.
Nederlands Tijdschrift Voor Geneeskunde
|January 8, 1994
Summary
Transcatheter embolisation effectively treated active gastrointestinal bleeding in three patients, utilizing polyvinyl alcohol particles and microcoils. This minimally invasive technique offers a viable solution for complex hemorrhage cases.
Area of Science:
- Interventional Radiology
- Vascular Surgery
Background:
- Gastrointestinal hemorrhage presents significant management challenges, particularly in patients with altered anatomy or poor general condition.
- Transcatheter embolisation is an established endovascular technique for controlling active bleeding.
Observation:
- Three distinct cases of severe gastrointestinal hemorrhage were managed using transcatheter embolisation.
- Case 1: A 73-year-old woman with Henoch-Schönlein vasculitis experienced active bleeding from a pancreaticoduodenal artery branch, treated with polyvinyl alcohol (PVA) particles.
- Case 2: An 82-year-old woman with cardiac decompensation and post-papillotomy bleeding was treated by embolising the inferior posterior pancreaticoduodenal artery with PVA particles.
- Case 3: A 75-year-old male with post-pancreaticoduodenectomy hemorrhage from the right hepatic artery was successfully treated using microcoils and a coaxial balloon catheter.
Findings:
- Superselective embolisation with PVA particles successfully arrested hemorrhage in the first two cases.
- Combined use of microcoils and a coaxial balloon catheter achieved hemostasis in the third complex case.
- All patients were discharged in good condition with no recurrence of bleeding.
Implications:
- Transcatheter embolisation is a safe and effective treatment for active gastrointestinal hemorrhage, even in challenging clinical scenarios.
- The choice of embolic material (PVA particles, microcoils) can be tailored to the specific angiographic findings and patient condition.
- This technique provides a crucial therapeutic option for patients unsuitable for conventional surgery or when local anatomy is compromised.