title: Superselective microcoil embolization of colonic hemorrhage.
abstract: OBJECTIVE
  We evaluated therapeutic microcoil embolization in a group of patients with severe colonic hemorrhage.
  
  
  METHODS
  Twenty-seven patients with severe colonic bleeding due to diverticular disease (n = 19), angiodysplasia (n = 6), cecal ulcer (n = 1), or unknown cause (n = 1) underwent attempted microcoil embolization (n = 25). Microcatheters were used in all procedures, and embolization was performed at the level of the vasa recta or the marginal artery of Drummond. Branches of the superior mesenteric artery were embolized in 12 patients, branches of the inferior mesenteric artery were embolized in 12 patients, and branches of both the superior and inferior mesenteric arteries were embolized in one patient.
  
  
  RESULTS
  Technical success was achieved in 93% (25/27) of the procedures. However, immediate hemostasis occurred in 96% (26/27) of patients because in one failed procedure, an occlusive dissection of the inferior mesenteric artery arrested bleeding. Three patients rebled within 24 hr. One patient was treated with endoscopic cauterization, and two patients underwent right hemicolectomy. One patient who underwent right hemicolectomy for rebleeding had ischemic changes found on pathologic analysis of the resected specimen, and a second patient who underwent embolization of branches of the superior and inferior mesenteric arteries developed bowel infarction requiring left hemicolectomy. Prolonged clinical success occurred in 81% (22/27) of patients.
  
  
  CONCLUSIONS
  Therapeutic microcoil embolization for severe colonic hemorrhage is an effective and well-tolerated procedure.
authors.affiliation: Department of Radiology, The University of Chicago Hospitals, 5841 S. Maryland Ave., MC 2026, Chicago, IL 60637, USA.
authors.forename: B
authors.initials: B
authors.lastname: Funaki
authors.forename: J K
authors.initials: JK
authors.lastname: Kostelic
authors.forename: J
authors.initials: J
authors.lastname: Lorenz
authors.forename: T V
authors.initials: TV
authors.lastname: Ha
authors.forename: D L
authors.initials: DL
authors.lastname: Yip
authors.forename: J D
authors.initials: JD
authors.lastname: Rosenblum
authors.forename: J A
authors.initials: JA
authors.lastname: Leef
authors.forename: C
authors.initials: C
authors.lastname: Straus
authors.forename: G X
authors.initials: GX
authors.lastname: Zaleski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index