title: New advances in lower gastrointestinal bleeding management with embolotherapy.
abstract: Lower gastrointestinal bleeding (LGIB) is associated with high morbidity and mortality. Embolization is currently proposed as the first step in the treatment of acute, life-threatening LGIB, when endoscopic approach is not possible or is unsuccessful. Like most procedures performed in emergency setting, time represents a significant factor influencing outcome. Modern tools permit identifying and reaching the bleeding site faster than two-dimensional angiography. Non-selective cone-beam CT arteriography can identify a damaged vessel. Moreover, sophisticated software able to detect the vessel may facilitate direct placement of a microcatheter into the culprit vessel without the need for sequential angiography. A further important aspect is the use of an appropriate technique of embolization and a safe and effective embolic agent. Current evidence shows the use of detachable coils (with or without a triaxial system) and liquid embolics has proven advantages compared with other embolic agents. The present article analyses these modern tools, making embolization of acute LGIB safer and more effective.
authors.affiliation: 1 Interventional Radiology Unit, Radiology Department, Uninsubria, Varese, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Ierardi
authors.affiliation: 2 Vascular and Interventional Radiology Department, Jiménez Díaz Foundation University Hospital, Madrid, Spain.
authors.forename: Josè
authors.initials: J
authors.lastname: Urbano
authors.affiliation: 1 Interventional Radiology Unit, Radiology Department, Uninsubria, Varese, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Marchi
authors.affiliation: 1 Interventional Radiology Unit, Radiology Department, Uninsubria, Varese, Italy.
authors.forename: Camilla
authors.initials: C
authors.lastname: Micieli
authors.affiliation: 1 Interventional Radiology Unit, Radiology Department, Uninsubria, Varese, Italy.
authors.forename: Ejona
authors.initials: E
authors.lastname: Duka
authors.affiliation: 3 Institute of Radiology, Second University of Naples, Napoli, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Iacobellis
authors.affiliation: 1 Interventional Radiology Unit, Radiology Department, Uninsubria, Varese, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Fontana
authors.affiliation: 1 Interventional Radiology Unit, Radiology Department, Uninsubria, Varese, Italy.
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Carrafiello
mesh_terms: D054893:Cone-Beam Computed Tomography; D004621:Embolization, Therapeutic / Q000379:methods*; D004636:Emergency Service, Hospital; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging* / Q000628:therapy*; D041981:Gastrointestinal Tract / Q000000981:diagnostic imaging; D006801:Humans