title: Microcoil embolization for acute lower gastrointestinal bleeding.
abstract: OBJECTIVE
  To assess outcomes after microcoil embolization for active lower gastrointestinal (GI) bleeding.
  
  
  METHODS
  We retrospectively studied all consecutive patients in whom microcoil embolization was attempted to treat acute lower GI bleeding over 88 months. Baseline, procedural, and outcome parameters were recorded following current Society of Interventional Radiology guidelines. Outcomes included technical success, clinical success (rebleeding within 30 days), delayed rebleeding (>30 days), and major and minor complication rates. Follow-up consisted of clinical, endoscopic, and pathologic data.
  
  
  RESULTS
  Nineteen patients (13 men, 6 women; mean age +/- 95% confidence interval = 70 +/- 6 years) requiring blood transfusion (10 +/- 3 units) had angiography-proven bleeding distal to the marginal artery. Main comorbidities were malignancy (42%), coagulopathy (28%), and renal failure (26%). Bleeding was located in the small bowel (n = 5), colon (n = 13) or rectum (n = 1). Technical success was obtained in 17 patients (89%); 2 patients could not be embolized due to vessel tortuosity and stenoses. Clinical follow-up length was 145 +/- 75 days. Clinical success was complete in 13 (68%), partial in 3 (16%), and failed in 2 patients (11%). Delayed rebleeding (3 patients, 27%) was always due to a different lesion in another bowel segment (0 late rebleeding in embolized area). Two patients experienced colonic ischemia (11%) and underwent uneventful colectomy. Two minor complications were noted.
  
  
  CONCLUSIONS
  Microcoil embolization for active lower GI bleeding is safe and effective in most patients, with high technical and clinical success rates, no procedure-related mortality, and a low risk of bowel ischemia and late rebleeding.
authors.affiliation: Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215-5400, USA. bjanne@caregroup.harvard.edu
authors.forename: B Janne
authors.initials: BJ
authors.lastname: d'Othée
authors.forename: Bertrand Janne
authors.initials: BJ
authors.lastname: d'Othée
authors.forename: Padmaja
authors.initials: P
authors.lastname: Surapaneni
authors.forename: Dmitry
authors.initials: D
authors.lastname: Rabkin
authors.forename: Imad
authors.initials: I
authors.lastname: Nasser
authors.forename: Melvin
authors.initials: M
authors.lastname: Clouse
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012189:Retrospective Studies; D016896:Treatment Outcome