Long-term results of microcoil embolization for colonic haemorrhage: how common is rebleeding?
OBJECTIVE
To determine the long-term results of patients undergoing transcatheter coil embolization for the treatment of acute colonic haemorrhage.


METHODS
Patients undergoing angiography for suspected colonic bleeding between January 2002 and December 2012 were reviewed (average age, 60 years; 38.4% male). Baseline, procedural and outcome parameters were recorded following the Society of Interventional Radiology guidelines. Primary outcome measures included early (<30 days) and delayed (>30 days) rebleeding events and adverse procedure-related complication. Average follow-up time was 996 days (median, 232 days; range, 30-3663 days).


RESULTS
One or multiple sites of bleeding were identified in 40 cases. Coil embolization was performed in 39 patients, 26 (66.7%, 26/39) of whom were treated successfully without technical/clinical failure (n = 12) or loss to follow-up (n = 1). Three patients (11.5%, 3/26) rebled in the early period within 30 days; one patient went on to hemicolectomy. Four patients (15.3%, 4/26) experienced delayed rebleeding after 30 days; two of whom also underwent hemicolectomy. No major complication occurred. One minor complication of short segment arterial dissection was seen in the clinical failure group. One case of asymptomatic ischaemia was identified on a patient undergoing pre-operative colonoscopy for elective bowel resection. No instances of ischaemic stricture were seen. All-cause mortality of successfully treated and all patients at 1 year was 31% (8/26) and 30% (12/40), respectively.


CONCLUSIONS
Transcatheter coil embolization is a durable treatment option with a technical and clinical success rate of 67% in the setting of acute colonic haemorrhage. A modest level of rebleeding was seen among successfully treated patients in both the early and delayed periods; in the majority of patients, embolization proved to be definitive therapy.


CONCLUSIONS
Transcatheter coil embolization is a durable and potentially definitive therapy in the management of acute colonic haemorrhage.
Department of Radiology, University of Chicago Hospitals, Chicago, IL, USA.
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http://orcid.org/0000-0003-2440-2437
O
Ahmed
Department of Radiology, University of Chicago Hospitals, Chicago, IL, USA.
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D
Jilani
Department of Radiology, University of Chicago Hospitals, Chicago, IL, USA.
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S
Sheth
Department of Radiology, University of Chicago Hospitals, Chicago, IL, USA.
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M
Giger
Department of Radiology, University of Chicago Hospitals, Chicago, IL, USA.
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B
Funaki
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization; D003082:Colectomy; D003108:Colonic Diseases / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult