Ultraselective embolization using a 1.7-Fr catheter and soft bare coil for small intestinal bleeding.
OBJECTIVE
We aimed to evaluate the safety and efficacy of embolization using a 1.7-Fr catheter and soft bare coil to treat acute small intestinal bleeding.


METHODS
Subjects were five consecutive patients who experienced onset of melena with small intestinal bleeding and underwent transcatheter arterial embolization with 1.7-Fr catheters and 0.010-inch detachable bare coils (five procedures in total). Technical success, clinical success, relative post-procedural complications, arterial bleeding source and cause, and relationship between coagulopathy and embolization efficacy were examined by capsule endoscopy.


RESULTS
We achieved 100% technical and clinical success for the five transcatheter arterial embolizations. All catheterizations of the vasa recta of the bleeding artery (jejunal artery, n = 2; ileal artery, n = 3) were possible with a 1.7-Fr catheter. We achieved high embolization efficacy in two patients with coagulopathy. No rebleeding, intestinal ischemia, or necrosis was observed on follow-up capsule endoscopy. We confirmed that peptic ulcers/ulcer scars were the cause of bleeding for all patients.


CONCLUSIONS
Embolization with 0.010-inch coils using a 1.7-Fr catheter and catheterization of the vasa recta of bleeding vessels was effective and safe for treating small intestinal bleeding.
a Department of Radiology , Kurume University School of Medicine , Kurume , Fukuoka , Japan.
Masamichi
M
Koganemaru
a Department of Radiology , Kurume University School of Medicine , Kurume , Fukuoka , Japan.
Masaaki
M
Nonoshita
a Department of Radiology , Kurume University School of Medicine , Kurume , Fukuoka , Japan.
Ryoji
R
Iwamoto
a Department of Radiology , Kurume University School of Medicine , Kurume , Fukuoka , Japan.
Asako
A
Kuhara
a Department of Radiology , Kurume University School of Medicine , Kurume , Fukuoka , Japan.
Masakazu
M
Nabeta
a Department of Radiology , Kurume University School of Medicine , Kurume , Fukuoka , Japan.
Masashi
M
Kusumoto
a Department of Radiology , Kurume University School of Medicine , Kurume , Fukuoka , Japan.
Tomoko
T
Kugiyama
a Department of Radiology , Kurume University School of Medicine , Kurume , Fukuoka , Japan.
Shuji
S
Nagata
a Department of Radiology , Kurume University School of Medicine , Kurume , Fukuoka , Japan.
Toshi
T
Abe
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057785:Catheters; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
Small intestinal bleeding; capsule endoscopy; coil embolization; lower gastrointestinal hemorrhage