Microcoil embolization for acute lower gastrointestinal bleeding.
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.
d'Othée
B Janne
BJ
Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215-5400, USA. bjanne@caregroup.harvard.edu
d'Othée
Bertrand Janne
BJ
Surapaneni
Padmaja
P
Rabkin
Dmitry
D
Nasser
Imad
I
Clouse
Melvin
M
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