title: The efficacy and long-term outcome of microcoil embolotherapy for acute lower gastrointestinal bleeding.
abstract: OBJECTIVE
  To evaluate the clinical efficacy as well as long-term clinical outcomes of superselective microcoil embolization for lower gastrointestinal bleeding (LGIB).
  
  
  METHODS
  Between 1997 and 2009, 26 patients with intended transcatheter embolotherapy for LGIB were retrospectively reviewed. Embolization was performed only when the catheter could be advanced to or distal to the mesenteric border of the bowel. The main purpose of our study was to assess technical success, recurrent bleeding rate and complications. We also evaluated the long-term clinical outcome, including late recurrent LGIB, bowel ischemia and the survival rate.
  
  
  RESULTS
  Twenty-two bleeding sources were in the territory of superior mesenteric artery and four in the inferior mesenteric artery. Technical success was achieved in 22 patients (84.6%). The target vessel of embolization was vasa recta in seventeen patients and marginal artery in the remaining five patients. Early rebleeding occurred in two patients (7.7%) and bowel ischemia in two patients, of whom the embolized points were both at the marginal artery. Delayed recurrent bleeding (> 30 days) occurred in two angiodysplasia patients. Five patients (19.2%) died within the first 30 days of intervention. Long-term follow-up depicted estimated survival rates of 58.2 and 43.1% after one, and five years, respectively.
  
  
  CONCLUSIONS
  Transcatheter embolotherapy to treat LGIB is effective with low rebleeding and ischemic complications. Considering the advanced age and complex medical problems of these patients, the minimal invasive embolotherapy may be used as both a primary and potentially definitive treatment of LGIB.
authors.affiliation: Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan.
authors.forename: Hui-Chung
authors.initials: HC
authors.lastname: Teng
authors.forename: Huei-Lung
authors.initials: HL
authors.lastname: Liang
authors.forename: Yih-Huie
authors.initials: YH
authors.lastname: Lin
authors.forename: Jer-Shyung
authors.initials: JS
authors.lastname: Huang
authors.forename: Chiung-Yu
authors.initials: CY
authors.lastname: Chen
authors.forename: Shang-Chieh
authors.initials: SC
authors.lastname: Lee
authors.forename: Huay-Ben
authors.initials: HB
authors.lastname: Pan
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D023381:Endpoint Determination; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Embolotherapy; Lower gastrointestinal bleeding; Microcoil