title: Selective microcoil embolization of arterial gastrointestinal bleeding in the acute situation:  outcome, complications, and factors affecting treatment success.
abstract: OBJECTIVE
  To evaluate microcoil embolization in the interventional treatment of acute upper and lower gastrointestinal bleeding.
  
  
  METHODS
  Forty-four patients (29 men, 15 women) with active arterial gastrointestinal bleeding were treated with microcoil embolization. The analysis included technical/clinical success, morbidity, mortality, and intervention-related mortality. Age, sex, underlying malignant disease, number of embolizations, preinterventional and postinterventional hemoglobin levels, blood products administered peri-interventionally, amount of embolization material used, duration of fluoroscopy, and use of contrast medium were evaluated for possible effects on technical and clinical success.
  
  
  RESULTS
  The primary technical success rate of microcoil embolization for acute gastrointestinal bleeding was 88.6% with a clinical success rate of 56.8%. Minor and major complications occurred in 13.6 and 18.2% of patients, respectively. Intervention-associated mortality, due to intestinal ischemia, accounted for 4.6% of the total 18.2% mortality rate. Patients with technically successful embolization had a statistically significant increase in hemoglobin (P<0.01) after the intervention and a decrease in need for packed red blood cells, (P<0.01), fresh frozen plasma (P<0.01), and coagulation products (P<0.01). A smaller postinterventional fresh frozen plasma requirement was associated with a better clinical outcome (P=0.02).
  
  
  CONCLUSIONS
  Microcoil embolization of arterial gastrointestinal bleeding in the acute situation has a high-technical success rate. The number of transfusions required before and after the intervention has no significant effect on technical success. Postinterventional fresh frozen plasma demand negatively correlates with clinical success.
authors.affiliation: Department of Radiology and Neuroradiology, Ernst Moritz Arndt University Greifswald, Sauerbruchstrasse, Germany. menselb@uni-greifswald.de
authors.forename: Birger
authors.initials: B
authors.lastname: Mensel
authors.forename: Jens-P
authors.initials: JP
authors.lastname: Kühn
authors.forename: Matthias
authors.initials: M
authors.lastname: Kraft
authors.forename: Christian
authors.initials: C
authors.lastname: Rosenberg
authors.forename: Lars
authors.initials: L
authors.lastname: Ivo Partecke
authors.forename: Norbert
authors.initials: N
authors.lastname: Hosten
authors.forename: Ralf
authors.initials: R
authors.lastname: Puls
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016913:Blood Component Transfusion; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D006454:Hemoglobins