title: Endovascular embolization for managing anastomotic bleeding after stapled digestive tract anastomosis.
abstract: BACKGROUND
  Anastomotic bleeding is an infrequent but life-threatening complication after stapled digestive tract anastomosis. Endovascular embolization is one of the available treatments, but precise clinical outcomes are yet to be evaluated.
  
  
  OBJECTIVE
  To evaluate the efficacy and safety of endovascular embolization for managing anastomotic bleeding after stapled digestive tract anastomosis.
  
  
  METHODS
  Twenty-eight patients were diagnosed with anastomotic bleeding after stapled digestive tract anastomosis by digital subtraction angiography (DSA). Curative effect was summed for analysis.
  
  
  RESULTS
  All bleeding arteries were located in the stoma and were identified by contrast agent spillover by DSA. The offending arteries were superselectively catheterized and embolized with microcoils and/or gelatin sponge particles. Laboratory examinations showed normal hemoglobin and red blood cell counts when the patients' abdominal cavity drainage tubes stopped draining blood. The follow-up period was 3.2-84.7 months (median, 19.7 months). Four patients died during this time, of which two had cholangiocarcinoma, one had gastric cancer with tumor recurrence and multiple organ failure, and the final patient had a subarachnoid hemorrhage 4 months after embolization. In the surviving patients, no rebleeding occurred after embolization and no additional intervention or surgery was required.
  
  
  CONCLUSIONS
  Endovascular embolization is safe and effective for managing anastomotic bleeding after stapled digestive tract anastomosis.
authors.affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
authors.forename: Teng-Fei
authors.initials: TF
authors.lastname: Li
authors.affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
authors.forename: Xu-Hua
authors.initials: XH
authors.lastname: Duan
authors.affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
authors.forename: Jian-Zhuang
authors.initials: JZ
authors.lastname: Ren
authors.affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
authors.forename: Kai
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
authors.forename: Guo-Hao
authors.initials: GH
authors.lastname: Huang
authors.affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China hanxinwei2006@163.com.
authors.forename: Xin-Wei
authors.initials: XW
authors.lastname: Han
authors.affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
authors.forename: De-Chao
authors.initials: DC
authors.lastname: Jiao
authors.affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
authors.forename: Meng-Fan
authors.initials: MF
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods*; D057868:Anastomotic Leak / Q000000981:diagnostic imaging / Q000628:therapy*; D015901:Angiography, Digital Subtraction; D013505:Digestive System Surgical Procedures; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000000981:diagnostic imaging / Q000628:therapy*; D017792:Surgical Stapling; D016896:Treatment Outcome
keywords: Angiography; anastomotic bleeding; embolization