Safety and efficacy of superselective angioembolization in control of lower gastrointestinal hemorrhage.
BACKGROUND
We evaluated the safety and efficacy of angioembolization to control lower gastrointestinal hemorrhage.


METHODS
Retrospective chart review of patients undergoing angiography for lower gastrointestinal hemorrhage from January 2000 to December 2002.


RESULTS
Seventy-seven patients with lower gastrointestinal hemorrhage underwent mesenteric angiography. Angioembolization was performed in 11 patients. Sixty-six patients were not embolized; 47 of these were treated medically and 19 surgically. Mortality rate was not significantly different in patients treated surgically (3 of 19, 16%) versus those managed medically (6 of 47, 13%; P = 0.746). Of the 11 patients who were embolized, 10 had immediate cessation of hemorrhage, 7 had gastrointestinal ischemia, and 6 died (55%). Overall mortality in non-embolized patients was 9 of 66 (14%; P = 0.002 versus mortality in embolized patients).


CONCLUSIONS
Angioembolization, though effective at controlling hemorrhage, is associated with ischemic complications and a high mortality rate. Our data support surgical or medical management for lower gastrointestinal hemorrhage.
Silver
Andrea
A
Department of Colon and Rectal Surgery, William Beaumont Hospital, 3601 West 13 Mile Rd, Royal Oak, MI 48073, USA. hiho70@yahoo.com
Bendick
Philip
P
Wasvary
Harry
H
D000368:Aged; D000369:Aged, 80 and over; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D006471:Gastrointestinal Hemorrhage / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007410:Intestinal Diseases / Q000401:mortality / Q000628:therapy*; D007511:Ischemia / Q000209:etiology* / Q000401:mortality; D041741:Lower Gastrointestinal Tract / Q000098:blood supply*; D008638:Mesenteric Arteries; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome